Speaking Request Form
Please fill out this form and click submit. Someone will be in touch with you soon!
Organization Information
Church Name
*
Senior Pastor
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Phone
*
Website
*
Contact Person Information
Name
*
Phone
*
May We Text You?
*
Please select one option.
Yes
No
Select Option
Yes
No
Email
*
This address will receive a confirmation email
Fax
*
Event Information
Dates of the Event
*
Times of the Event
*
Dates Requested
*
Church/Venue Name
*
Church/Venue Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Seating Capacity of the Church/Venue
*
Expected Attendance of Event
*
Brief Description of Event & It's Purpose
*
Others Ministering
Has Pastor Bo ever ministered in your church?
*
Please select one option.
Yes
No
Select Option
Yes
No
How did you first hear about Pastor Bo?
*
Will Pastor Bo be able to receive a special love offering for his ministry or will the church be preparing that?
*
Please select one option.
Pastor Bo may receive a special love offering
The church will be preparing that.
Select Option
Pastor Bo may receive a special love offering
The church will be preparing that.
Will Pastor Bo be permitted to sell product if desired to do so?
*
Please select one option.
Yes
No
Select Option
Yes
No
May we have at least two tables to display and sell ministry products?
*
Please select one option.
Yes
No
Select Option
Yes
No
Can you provide at least two volunteers to help work the tables?
*
Please select one option.
Yes
No
Select Option
Yes
No
Airport Information (If Applicable)
Nearest Commercial Airport to Your Location
Driving Time from Airport to Hotel
Hotel Information (If Applicable)
Will hotel accomodations be provided?
Please select one option.
Yes
No
Select Option
Yes
No
Hotel Name
Hotel Address
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Hotel Phone
Hotel Fax
Nearby Restuarants
Driving Time from Hotel to Venue
Submit
Description
Please fill out this form and click submit. Someone will be in touch with you soon!
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