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This seminar request form is specifically for those interested in hosting CPYU's Tackling The Tough Stuff seminar. Due to the large number of requests we receive for on-site speaking and seminar engagements, the Center for Parent/Youth Understanding has established a screening process to help us discern and manage our seminar/speaking schedule. While we would like to be able to fulfill all speaking/seminar requests, we are unable to do so. In order to allow our staff an opportunity to give prayerful and serious consideration to your request, we are asking you to complete the Seminar Request Form in its entirety. After receiving your completed form, we will contact you regarding seminar/speaker availability for your requested dates. Thanks for your interest in hosting Tackling The Tough Stuff!

Requested Date:*
The following dates are available to host the Tackling The Tough Stuff seminar. We will fill the dates on a first come, first served basis. Check as many dates as you are available to host the event. Available dates are subject to change.
- February 18, 2017
- September 16, 2017
- September 23, 2017
- October 14, 2017
- October 21, 2017
- October 28, 2017
Church/Organization Name:*
Contact Name:*
First Last
Address:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone:*
Alternate Phone:
Email*
Do you intend to hold the event at the address provided above?*
- Yes
- No
Location of Event (If different from address provided above):
Street Address City State / Province / Region ZIP / Postal Code Country
Number of attendees expected:
Amount budgeted for Honorarium:*
Amount budgeted for Travel/Accommodation Expenses:*
What are your hopes for this event?
How does this event fit into your overall ministry strategy and objectives?
What type of publicity will you use?
Will the event be a cooperative effort with other churches/schools/etc.?
How did you hear about CPYU's Tackling The Tough Stuff seminar?
Name
This field is for validation purposes and should be left unchanged.

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