Booking Request Form

What is your full name? *

What is the name of your group, church, or organization hosting the event? *

What is the best telephone number to contact to finalize details for the event? *

What is your e-mail address? * Please double check and ensure it is entered correctly.

What is the Date of the Event? * If there are multiple potential dates please include all prospective dates in your booking request.

What is the address of the event? * Please include any information you have available. If the exact location is not available please give at least a city & state.

What Time is the event? * Ex. 5:00-8:30PM (If time is unknown indicate, Morning, Noon, or Evening? Please Include Start Time & End Time.)

At what time would you like Brad to speak? Ex. The event begins at 5:00pm but you would like Brad to speak at 6:15pm.

What is the Name of an On-Site Contact & Cell number in case of last-minute emergency on the day-of?

What is the size of your event? This number will be used to prepare promotional materials for your group.

• 15-30 People
• 30-50 People
• 50-100 People
• 100+

How much time will Brad have to speak? *

• 15 minutes
• 30 minutes
• 45 minutes
• As much or as little as he would like

What topics would you like Brad to speak on? * Please select all that apply...

• The Fight for Religious Freedom
• Faith in The Workplace
• Fully Equipped or one of his other Expository Sermons
• Reclaiming Your School :Religious Rights & Public Education
• The Church & Politics
• The Union Dues Project
• School Tracker : The Public School Policies Rating System
• Church Access & Outreach to the Public Square
• Moral Issues in the Church : Protecting your congregation in your church bylaws
• RLUIPA :The Religious Land Use and Institutionalized Persons Act (RLUIPA)

Does your group or event have a Website, Facebook, Twitter, or YouTube? Please include a link to all that apply...

Do we have permission to advertise and market your event on our Social Networks & Website? * We will post links to your event, articles about it, and any advertisements you have on your event pending approval. (We cannot post any marketing for any event endorsing a political candidate running for office.)

• Yes, You have our permission to promote this event on your website and social networks.
• No, You do not have our permission to promote this event on your website and social networks.

Do we have permission to ad you to our e-mail list to receive weekly updates? Please include a link to all that apply...

• Yes, Please ad me to your e-mail update list.
• No thank you, not at this time.
• I'm already on your list!

Do you have any additional comments or details you think we should know?

Send me a copy of my responses.