Shrine of the Black Madonna Bookstore: Event Form

Wednesday, August 27, 2008

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Shrine of the Black Madonna™ Cultural Center and Bookstore

Events / Book an Event

Event Request Form

Shrine of the Black Madonna offers spaces for variety of events. Our venues include chapels, galleries and book stores in Detroit, Atlanta and Houston. Use the form below to submit your request to use a shrine facility.

Contact Information:

*First Name:
*Last Name:
Organization Name:
Address:
Telephone:
Fax:
*Email:

Event Information:

Name of Event:
Preferred Event Date:	/ /
Optional Date #1:	/ /
Optional Date #2:	/ /
Optional Date #3:	/ /
Expected event start and end times:	to
Expected number of participants:
Preferred City:
Preferred Venue:
Preferred Event Type:
Other event details:

When is the best time to contact you to discuss this event:

Want to sell your book or product with The Shrine?
Download, complete and return our Consignment Application.