Engagement Booking Form

True Christians live a life of holiness. Hebrews 12:14

Engagement Booking Form

Thank you for your interest in having Holiness.com founder and author of the Dating Survival Guide, Just A Brother, as a guest at your event.

You may not be aware, but the founder of Holiness.com has been heard on hundreds of radio stations across the country from New York to Hawaii, including KGO, KMEL, WBGX, WICC, KRNA, WUSJ, KERN, and KWKJ. He's been counseling adults and Christian youth since the early '80s and has even written for secular audiences such Yahoo! Personals 8 million monthly visitors.

Below are questions Holiness.com asks that you have completed by one of the officers of your Church/Organization. This brief survey allows us to more efficiently determine your needs and how we can most effectively participate in your event.

Please complete the form below:

Your First Name:
Your Last Name:
Church or Organization:
Your Position:
Your Email Address:
Daytime Telephone#:
Your Street Address:
Apt Number:
City:
State/Province:
Zip/Postal Code:

Title of Event

Please briefly describe your event:

What would you like Holiness.com to do at your event:

Date of Event:
Start Time of Event:
End Time of Event:
Event City:
Event State/Province:
Event Country:
Estimated Attendance:

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