GGCSL Activity Packet-Click in gray boxes to input data
Submitted or Referred by: Date Submitted:
Speaker/Presenter Personal Information
Name:Phone:
Email:
Mailing Address:
Website: / 2nd Contact Name:
Phone:
Email:
Program Information
Name of Activity, Program or Event: / Proposed Date(s): Proposed Time:
Proposed Location:
Proposed Attendee Fee: $ per person / Split with GGCSL:
Expenses requested to be paid by GGCSL:
Type of Event:
Size of Event:
Small (up to 20) Medium (20-50) Large (50-250) Grand (250-500) Major Event (500+)
Description of Event – Your Vision and Intentions
Please describe for us your vision and intentions for this program or event. Please include a description of the Activities, outline of the schedule, agenda, etc. Feel free to provide additional sheet(s) if needed in order to provide a complete picture of the event. This field is completely expandable:
Previous Appearances and Speaking Engagements:
Please include any New Thought communities or churches that have hosted the Speaker/Presenter, as well as other appearances.
·
·
·
·
GGCSL Resources:
Please mark with an “X” any of the following resources requested for Event.
Lighting/Sound / Marketing/Promotion / Posters/Flyers
Product Sales / Invitations/Program / Location
Refreshments
Will Speaker/Presenter have support personnel in the planning process?
Will support personnel be available at the event?
Instructions for Submission:
1. Send completed application via email to:
or mail to: 199 Greenfield Ave., Suite B, San Rafael, CA 94901
2. Please include a website link, speaker photo, bio and other pertinent items for marketing collateral.
3. Application reviewed by Gateway CORE
4. Application Approval, Denial or Request for more information returned to Applicant within 30 days. /
Applicant Signature Date
Title
199 Greenfield Avenue, Suite B · San Rafael, CA 94901
Tel: 415.721.2492 · Fax: 415.721.7882
Web: http://www.ggcsl.org · E-mail: version 4/12/13