Invite “Boomer” To Speak At Your Event!

COMPLETE FORM BELOW - SERIOUS INQUIRIES ONLY

Type of Event

Program Selection

Name of Organization

Location (City,State)

Note: Darrin is available to be booked internationally.

Description of Event, Conference, or Service

Date of Event

Please List All Possible Dates, With Year Included.

Estimated Attendance

Can Product Be Brought and Sold?

Example: Books, Merchandise, etc.

Name of Contact Person

First Name

Last Name

Email of Contact Person

Phone Number of Contact Person

(###)

###

####

Website (Optional)

http://