Booking Request

If you are interested in scheduling Sammy for your next event please fill out the form below.

Your Name: *

Your Email: *

Date: *

Type of Event: *

Briefly describe the type of event you are planning.

Location and address of event site.: *

Overall purpose of the event.: *

Makeup of the attendees (e.g. age range, high school students, college students, singles, etc.): *

Estimated number of attendees: *

Will Sammy be the main speaker?: *

How many MAIN sessions are you requesting Sammy to speak for?: *

How many BREAKOUT sessions are you requesting Sammy to speak at?: *

Schedule and duration of speaking times. (e.g. Main session at 9:00 a.m. on 1/2/08, 1 hr. in length): *

Are there any particular topics you would like Sammy to speak about at your event?: *

If scheduling allows, Sam travels with his wife. Would you be willing to provide travel expenses for this priority in his life?: *

Additional Comments: