Request Form

Thank you for your interest in having me involved in your event. It is an honor that you are entrusting me with this request, and I do not take it for granted. Please fill out this form in its entirety. If there is a blank that is not applicable to your event, please enter "N/A" in the blank. I will try to respond to your request within three weeks of the time I receive it.

Event Information

What is the name of the event? *
Event Web Site:*
In what city will the event take place?*
Event Start Date:*
Event End Date:*
If dates are flexible, please list in chronological order other potential dates:
How many times do you want Denny to speak?*
What specific topics are you requesting Denny to cover?*
How long should he plan to speak for each message?*
What will be the event schedule (including the precise times of day Denny will speak)?*
Who is the main point of contact for this event?*
Contact E-mail:*
Contact Phone:*
What organization/church is sponsoring the event?*
What is the vision and purpose of the event?*
Who, in addition to Denny, will be speaking at this event?*
Who is the target audience?
How many attendees do you expect? *
When do you need a formal response from Denny?*

Location and Travel Information

What is the name of the event venue?*
What is the address of the event venue? *
Which airport would Denny fly in to? *
What is the travel time from the airport to the event location?*
When do you expect Denny to arrive at your location?*
When will Denny be available to return to Louisville?*
Which of Denny’s travel expenses will you be covering? *
To whom should reimbursements be submitted? *
Email of Reimbursement Contact:*
Phone Number of Reimbursement Contact:*
How would you like reimbursements submitted? (Email scanned receipts, Mail copies, etc.)*
Denny has no set fee for speaking engagements. But if you are going to offer him an honorarium, please specify the amount:*
Anything else?
Verify that you are a human:

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