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Speaking Engagement Request Form
  1. Please enter the information indicated below to request a speaking engagement for Pastor.

     

  2. Name of Person Requesting Speaker:
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  3. Name of Church or Organization Requesting Speaker
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  4. Name of Event
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  5. Location of Event
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  6. Date of Event
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  7. Time of Event
  8. Hour
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  9. Minutes
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  10. Meridian
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  11. Length of Presentation
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  12. Anticipated Number of Attendees
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  13. Theme
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  14. Scripture
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  15. Will the presentation be audio and/or video taped?
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  16. If so, for what purpose?
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  17. Will a hand-held microphone be available?
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  18. Will there be a monitor near the pulpit/lectern?
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  19. Will this event require an overnight stay?
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  20. When Air Travel is Required:

  21. Who will make flight arrangements?
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  22. Airline Preferences: United Airlines (aisle seat)

  23. Who will be meeting him at the airport?
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  24. Will honorarium be presented?
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  25. If so, when?
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  26. Amount of Honorarium: $
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  27. Contact Person(*)
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  28. Phone Number(*)
    Required format: ###-###-####
  29. Email Address
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  30. Description of Event
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  31. Please verify that this submission is valid by entering the letters and numbers from the image in the box below.

  32. Enter the letters and numbers from the image here.
    Enter the letters and numbers from the image here.
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