Organization
*
Organization Type
*
Church
College Campus
Student Ministry
Women's Ministry
Recovery Group
Other
Contact Person
*
First Name
Last Name
E-mail
*
Confirmation Email
example@example.com
Phone Number
*
Format: (000) 000-0000.
Event City, State (or indicate if virtual)
*
Preferred Event Date
*
-
Month
-
Day
Year
Date Picker Icon
Hour Minutes
AM
PM
AM/PM Option
Preferred Event Date (second choice)
-
Month
-
Day
Year
Date Picker Icon
Hour Minutes
AM
PM
AM/PM Option
Audience type
*
Women (adults)
Women (students)
Women (all ages)
Mixed Gender (adults)
Mixed Gender (students)
Other, please define
Audience Size
*
Please Select
Under 50
50-250
250-500
500-1000
1000+
Preferred Topic(s)
*
What Drives Women to Porn? (Training)
S.C.A.R.S.: Healing the Wounds of Sexual Addiction (Recovery)
SheRecovery: Not Just a Guy's Problem (Awareness/Prevention)
Redefining Identity: Our Past Does Not Define Us
Porn Culture: How Do We Fight It?
Your Kid is Watching Porn: A Warning for Parents
Single On Purpose: Answering God's Call Now (Singles)
Dating Done Right: Pursuing Relationships on Purpose (Singles)
Shades of Grey: The BDSM/Erotica Debate
Love of a Father: Healing Our View of God
Women's Mental & Emotional Health (emphasis on Depression/Anxiety)
Provide training in the area of female porn/sex addiction
Other, please define
Presentation Type (include number of sessions, length, etc.).
*
Honorarium/Budget
*
Will Crystal be allowed sell her books and other products at the event?
*
Yes
No
Comments (event details, budget concerns, anything else you think Crystal ought to know)
FOR EVENTS OUTSIDE OF KANSAS CITY AREA
Able to Provide Travel?
Yes
No
Able to Provide Hotel Accommodation?
Yes
No
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