Please
send form and payment to:
Gregath Co., PO BOX 505, Wyandotte, OK 74370.
Information provided here will be used for ongoing PR so please send this in with payment ASAP.
Name: ___________________________________________________________________________
Address: _________________________________________________________________________
Phone Number:_______________________________
Preferred Roommate (optional): _____________________________________________________________________________________________
_____________________________________________________________________________________________
______
I am handicapped and have cleared arrangements with
_________________________
(for reservation purposes only)
Email: ________________________________
Website: ________________________________
(___) Yes! You may use my Web contact information online and in the Syllabus.
(___) NO Do Not use my Web contact information online and in the Syllabus.
Speaking Topic/Requested Time Period - 1 hour before Q&A minimum (i.e. Saturday after dinner, Sunday AM, etc.): _____________________________________________________________________________________________
Presentation Equipment Requested:
_____________________________________________________________________________________________
Comments (include time on campus for a la carte):
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Speakers can not provide referral bonuses for others - though they are eligible for unlimited referral bonuses for attendees they refer.
Please also include biographical information and a photo.
Price includes Speaker Discount - one topic
____ Speaker Standard Full Retreat Package
@ $140.00 = $______________
Until
October 1, 2013 - as available
Special Loyalty
Invitation speakers will receive their compensation on
account or with their camp packet, or list different package price individually.
____ Day Tripper @ $5.00 (per extra session=speaking session) = $______________
____ Day Tripper @ $25.00 (per extra session) = $______________
Until
October 1, 2013 - as available
Price above Speaker Discount
____ Additional Day Tripper @ $25.00 each session = $______________
Until
October 1, 2013 - as available
Until October 1, 2013 - as available
Sessions: ___________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
NO
SHIPPING OR HANDLING FEES NEEDED
Page Last Updated:
December 21, 2017