Dr. Baker Appearance Request Form
Church or Organization Name
Organization Street Address Address (cont.) City State/Province Zip/Postal Code Country Phone E-mail URL
Please provide the following contact information
Name Title Work Phone Home Phone E-mail
Please Enter Today's Date
-- mm/dd/yy
Approximately when would you like to hold your event?
Type of event
Church Service Church Function Conference School Presentation Radio Program Other
Target Group?
Elementary Students High School Students Church Group Professional Group Other
Type of Presentation Requested
Seminar General Speaker Keynote Speaker Debate Interview Other
If you selected "Seminar" above, which one are you most interested in?
Dinosaurs Of Creation Evidence Of Global Flood Dinosaurs And The Flood Science vs.Textbook Evolution Sea Dragons Noah's Flood