Request a Presentation

Please be advised that we will make every effort to schedule your presentation based upon your preferred dates and times. However, in an effort to meet the needs of the churches, groups, and organizations we are working with, your flexibility is greatly appreciated. A representative of the Change the Culture Team will contact you directly if there is a need to coordinate a different date or time.


* First Name:
Middle Name:
* Last Name:
* Organization:
* Phone: ( ) -
Email:
Preferred Presentation Date:
Special Information/Comments:

Instructions: Fill out the form above and click the "Submit" button to send your information online, or print the form and fax it to:

Coalition to Change the Culture
Fax: 313-224-0818
Email: 3cv@co.wayne.mi.us

Disclaimer: Filling out this form does not guarantee your presentation date. Someone from our office will call you for more information regarding your request.