S.T.A.C.I.E. Foundation Event Request

Thank you for your interest in inviting Lorraine Whoberry to your special event. Please take a few moments to complete the following information.

* Required Fields
Contact & Organization Information
*Contact Name
*Contact Email
*Contact Phone
Contact Cell
*Organization Name
*Street Address
*City
*State or Province
*ZIP or Postal Code
Country
 
Event Location Information
Location Name
Type of Location Example: Theater, Retreat Center, Hotel, Etc.
Location Street Address
Location City
Location State or Province
Location ZIP or Postal Code
Location Country
Location Phone
 
Nearest Transportation Serivces
Airport
Train
Bus
 
My Role - Check All That Apply
  Staff Member
Event Coordinator
Committee Member
Special Events Coordinator
Other:
 
What were your deciding factors/reasons to invite Lorraine?
 
Topics of Interest
Check all that apply		 Impact of Victimization
Tragedy to Triumph
Working With Law Enforcement
Community Awareness
Dealing with the Court System
Execution from the Victims' Standpoint
Returning Home
Dealing with the Department of Corrections
True Forgiveness
Tender Road
Amazing Victory
Unsure
Other -
 
Desired Event Type Conference
Seminar
Benefit
Other
 
Number of Teaching Sessions Desired
  1
2
3
4
Other
 
Expected Attendance up to 100
up to 300
up to 700
up to 1200
Other -
 
Plese list your first 3 choices of dates
 


 
Event Day(s) Preferred Midweek
Friday Only
Friday and Saturday
Saturday Only
Other
 
Registration, Promotion & History Questions
Check All that apply
This is our first event with a guest speaker
We have held previous events with guest speakers or musicians
Our main focus is holding Conferences
This is a Non-Profit Benefit
We charge a registration fee
We sell tickets for our events
We offer our events at no charge due to corporate sponsorship
Our primary focus for events is our organization
Our events focus on Community Outreach
We advertise within our organization as it is not open to the public
We advertise our events throughout the community with internet and online social networking, and traditional marketing methods
We promote our events through radio and television
We need assistance in promoting this event outside our organization and would prefer to utilize your services
 
What Speakers and Organizations have you worked with in the past?
 
Questions, Comments or Additional Information