International Life Services
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Chastity Education Program
Speaker Request Form

Thank you for requesting a chastity speaker. Please allow a minimum of six weeks between submission of this form and your event so that suitable arrangements can be made. To be certain that we have sufficient information to make scheduling decisions, please fill out this form completely. When you have finished, Submit it to our office.

After your request has been received, our Speaker Coordinator, Ewa Maria Gizowski will contact you with speaker information. If you have any questions regarding the Chastity Education Program, please email lifeservices@juno.com or call 213-382-2156.

SPEAKER FEE: To assist in the cost of the Chastity Education Program there is a $200.00 per hour speaker fee which is to be sent to International Life Services upon receiving your speaker confirmation notice. For multiple presentations or presentations longer than two hours please call or email for the fee. Please make check payable to International Life Services. Thank you!

Please complete all sections before clicking the "send request" button. (NA if not applicable). Thank you.

School/Parish Name
Street Address
City, State, Zip
Primary Contact Name
phone
email
Date Requesting Speaker
Class Time
Class Time
Type of Class
Age of Students
Desired Topics
(or indicate No Preference)

  
note: Address for sending registration by mail is:
International Life Services
2606 1/2 West 8th Street Los Angeles, CA 90057
Phone: 213-382-2156 Fax: 213-382-4203
Email: lifeservices@juno.com
Attention: Sr. Paula Vandegaer
International Life Services
2606 1/2 W. 8th St.
Los Angeles, CA 90057
email: lifeservices@juno.com