I.  About Requesting Organization:

Name_____________________________________________________________


Mailing Address_____________________________________________________


Business Phone (_____)________________ Fax (___)______________________


Email___________________________ Website___________________________


How did you hear about us?___________________________________________


_________________________________________________________________


II. About Contact Person:

Name ____________________________________________________________


Cell phone (_____)___________________Email___________________________


III. Method of Payment: Credit Card Type______________________________


Name on Card__________________ Card #________________ Exp. _________


IV. About the Presentation:


Program(s) Requested:________________________________________


​__________________________________________________________


Day & Date & Time Requested_____________________________________________________


Alternate Day-Date-Time:_____________________________________________



Duration of time requested (30, 45, 60 min., etc.) _________________________


Number in audience (approx. OK)_____ Place_________________________ 


Directions:       


SCHEDULING & FEES

SPEAKER KEEPER JAMES RESERVATION FORM


  • You may phone this info to 252-996-0493;
  • or print and mail to Keeper James, P.O. Box 362, Rodanthe, NC 27968-0362;
  • or scan and email to KeeperJamesLSS@gmail.com.    Thank You!

THIS SECTION IS UNDER CONSTRUCTION. Revisions appearing SOON!!


FEES: Fees vary and are based on several factors: type of performance, location, etc.​


Plus travel expenses. IF OVERNIGHT TRAVEL IS REQUIRED, must include lodging and meals. We will work with you to make this good for all.


PLEASE make reservations well in advance.


50% DEPOSIT required.


CANCELLATIONS less than 24 hours will forfeit the deposit