Tanda Canion Ministries Request Form(Local)

Local Request Form
Please fill out the form completely. Incomplete information will delay processing. Form will not be submitted without required information. If item does not apply, please skip to the next item.
Church Information

Please provide information regarding your ministry
Please check appropriate box:*

New FellowshipFormer Fellowship
If New Fellowship, who do we have to "Thank" for this referral?*
Church/Organization Name:*
Pastor/Organization Director*
E-mail
example@example.com
Church Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church Fax*

Area CodePhone Number
Church Phone Number*

Area CodePhone Number
Contact Information

Please provide contact information
Full Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Alternate Contact Name

First NameLast Name
Alternate Contact Email
example@example.com
Alternate Contact Number

Area CodePhone Number
The Service

Please provide details about the Service
Please give the ministry dates (include day(s) and time(s)for example Monday, April 12, 2022 at 7:00pm*
Type of Service*
Theme
Please list any additional speakers
Please provide expected attendees. (This will allow us to properly prepare our ministry product)*
Special attire/color requested? If so, please describe.*
Is the Service for:*

Women OnlyMen OnlyBothOther
If other, please specify
Location of Service:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please Note: If the Speaker is required to travel by car for 1.5 hours or more, speaker request that host ministry provides a rental car plus gas allotment. Airline ticket might be required.
Please specify rental car information and amount for gas allotment (if applicable).
Honorarium

Please provide details about the speaker honorarium to avoid any miscommunications or division as stated in 1Corinthian 1:10
Honorarium
Is the honorarium a percentage or set amount? Additional Offering will not be raised if specific honorarium is established unless previously arranged). Please specify percentage amount.*
Would your ministry like for Dr. Canion to raise the offering?

Yes(Please review previous information)NoUndecided
Ministry Resources
Can Ministry provide a 6 or 8 foot table(s)in the main flow of traffic to display Dr. Canion's ministry resources*
If Dr.Canion's adjutants are not present, can ministry appoint 2 people to be responsible for resources?*
Please verify that you are human*
Should be Empty:

Local Request Form

Church Information

Contact Information

The Service

Honorarium

Ministry Resources