Form Test

Midst booking form
Would you like to start a booking process?
- Yes
- No
• Don't worry if you change your mind, just click 'No'..
• Not ready to complete a booking form? Perhaps a phone chat first would be more helpful for you?
• To contact MIDST/Phil Day directly by phone, try +61 (0)417 116 970
• A name and email address is required below so a response can be sent to you.
• An asterisk * indicates a required field.
Type of help requested*
- Presentation
- Initial consultancy, let's see where it goes.
- Consultancy &/or review including mentoring/coaching
- Training
- Combination of presentation & training
- Choose one …
Background*
What information would you like to provide as background to your request?
Context, history, needs, issues, problems, why it's a problem … anything.
For this or any of the responses below, any jottings, dot points, helpful insights … all good!
If it would be helpful to talk this through first, that’s OK … just type ‘Let’s talk!’
Input sought*
What input would you envisage from Midst/Phil Day? Please be as general or as specific as you like … content, topics, possibilities, style. If it would be helpful to talk this through first, that’s OK … just type ‘Let’s talk!’
Outcomes*
Overall, what positive, helpful, prayerful outcomes would you love to see as a result of Midst/Phil Day's involvement? Again, if it would be helpful to talk this through first, that’s OK … just type ‘Let’s talk!’
Your details
Please provide at least the minimum details in order to contact you.!
Preferred name for emails & phone conversations.*
The name you would like to be called. E.g. Phil, Pastor Bob, Mr. Russell, Ms Smith, Ruth, Jacko
Last name*
Email*
A valid email is required. A confirmation message with your booking request will be sent to this email address.
Church/organisation
For churches, please include full name, denomination, suburb, city.
Church/organisation website
Optional … If you have a website please give this including the http://
(Probably best to cut & paste the actual web address)
Your role/position
#1 Contact phone number
A daytime number if possible.
#2 Contact phone number
If any
Fee/donation options*
A discussion regarding fees &/or donations may be found here>
Have you checked this out?
- Yes I have.
- No, not yet.
Consultancies
Complete this field ONLY if this booking is for some form of initial consultancy, consultancy, review, coaching, mentoring.
• What days or times generally suit? List a couple of options.
• Another possibility is a Video/Audio Skype call if that works for you. If so, please add your Skype details.
• Ignore the fields below related to 'events'. Leave them blank.
Events
Complete this section ONLY if this booking is for a presentation &/or a training event.
Style of event
What sort of event will the presentation or training be a part of?
Conference, Training day, Training session, Family camp, 10am worship, Kids Church, Holiday program, Parenting session/s …
Name of event
Just type 'event' if it hasn't a name yet.
Date/time of event
Day: Date: Start Time of Event: Finish time of event
If this is yet to be determine, type 'tbd' and add suggested dates and times.
Location of event
Please including full venue name & full venue address.
General description/nature of event
• Who comes, who are you expecting, approx. numbers of children/families/others/leaders
• Who are the organisers, how does this event generally run? First time? …
• Again, any jottings, dot points, helpful insights … all good!
Thank you for making a booking!
Just a security step to go …
Note: After the 'human test', clicking [Submit] should take you to a 'Thank You' page.
If this doesn't happen, scroll down the resulting page to see if there are errors in your submission.
Are you human?*
If you are a reasonable human, we reckon you know the answer to 3 plus 2 … is it the same as???
- 2x2
- 1+4
- 2x3
- 5+2
- 4x2
Email
This field is for validation purposes and should be left unchanged.

MIDST booking request

Midst booking form

Your details

Consultancies

Events

Thank you for making a booking!