Tanda Canion Ministries Request Form (Out of State)

Out of State 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/Organization Name:*
Pastor/Organization Director*
Church/Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church Phone Number*

Area CodePhone Number
Church Fax*

Area CodePhone Number
E-mail
example@example.com
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 there a registration fee? What is the deadline for payment? Are Armor Bearers complimentary?*
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
Honorarium

Please provide details about the speaker honorarium to avoid any miscommunications or division as stated in 1Corinthian 1:10
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 an offering to be raised?*

Yes(Please review previous information)NoUndecided
Travel Accomodations

Please provide information regarding the speaker's travel arrangement. Please note: If speaker is required to travel more than 1.5 hours or more, speaker request that host ministry provide a rental car and gas allotment(negotiable). Depending on schedule,distance, airline ticket is required.

Delta is the preferred airline (Account#2320977172)

*ALL TRAVEL (AIR/RENTAL) NEED TO BE BOOKED THROUGH DR.CANION'S PERSONAL BOOKING AGENT

RICHARD SCHUTKIN

(Toll-Free) 1-800-776-7011,(Office)414-769-4800
If rental is decided by Tanda Canion Ministries, please list gas allotment?
Hotel Accomodations

Please provide hotel information for the speaker
**Please ensure that the hotel room key is available upon his/her arrival to avoid having to stop at the front desk**

Note: For Out of State Travel, Please provide the following:

*Meals

*Ground Transporation

*Personal Greeter (To greet her at the airport or upon arrival)
Hotel Name
Hotel Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Hotel Phone Number

Area CodePhone Number
Personal Greeter Name

First NameLast Name
Phone Number

Area CodePhone Number
Ministry Resources
Could your ministry provide a 6 or8 ft table(s) in the main flow of traffic to display Dr. Canion's ministry resources?
If Dr. Canion's adjutants are not present, would your ministry appoint 2 people to be responsible for resources?
Does your ministry request to receive her:
Send info via:

MailEmailFax
Please verify that you are human*
Should be Empty:

Out of State Request Form

Contact Information

The Service

Travel Accomodations

Hotel Accomodations

Ministry Resources