Speaking Request Form « Heart of the Artist

Contact Person's Name*(required)
Phone*(required)
Email Address(valid email required)
Name of Church or Organization
Church Street Address*(required)
City, State, Zip*(required)
Date(s) you'd like to book Rory to speak*(required)
How many times will Rory be speaking and for how long?
What is the nature of this event and how many people will be attending
Where will the event be held?
Is there any other information that you'd like to provide at this time?
Please note: a non-refundable deposit of $500 is due once the date of the retreat is confirmed.

Social Links