ChristianCounsel Clinics
where enjoying God is the path to recovery
Seminar Request
Book Rob Jackson for Your Church

Please tell us about yourself and your request. We'll be in contact with you within two business days.
 
Title:
First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Email:
Church name:
Preferred seminars (please check all that apply):  Covenant Marriage Seminar
"Talk to Your Kids" Parenting Seminar
 Men's Seminar
Women's Seminar
To be determined with you
Preferred dates of service::
Location of event (Please include any building name if applicable, street address, city, state and zip code.):
Approximate size of audience:
Is audio/visual equipment available (please check all that apply)?  dry chalk board and markers
lapel microphone
overhead projector (for laptop)
computer with Internet connection
slide screen
slide screen
Directions/special instructions:
Comments:

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at 1.888.891.HOPE (in the U.S.) or 1.719.440.4893.
Locations in Colorado Springs, CO and Olive Branch, MS [learn more]


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