Speaker Invitation Form
Dr. Ariesha Murray and or Pastor Anthony Murray. Please allow 24-48 hours for response.
Who are You Inviting To Speak?
*
Dr. Ariesha Murray
Pastor Anthony Murray
Pastor Anthony and Dr. Ariesha Murray
Your Name
*
First Name
Last Name
Your Contact Email
*
example@example.com
Your Contact Phone Number
Format: (000) 000-0000.
Name of Church, Ministry, or Company
*
Church, Ministry, or Company Website
*
Name of Requested Event or Conference
*
Theme(s) and/or Focus of Gathering
Date of Event
*
/
Month
/
Day
Year
Date
Expected Number of Attendees
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Event Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Will an Honorarium be Provided if a Church or Ministry?
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Yes
No
N/A
Will you Commit to provide half of the booking fee 3 days before the Event if a Business?
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Yes
No
N/A
Will Hotel and Travel Expenses be Reimbursed?
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Yes
No
Number of Speaking Sessions Requested
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Please List The Day(s) and Time(s) You Would Like Dr. Ariesha and/or Pastor Anthony to Speak
Will There be a Resource Table Available?
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Yes
No
Will There be a Volunteer Available to Run the Resource Table?
*
Yes, we will have a volunteer available.
No, Dr. Ariesha and/or Pastor Anthony will need to provide someone to run their resource table.
Please select the topic you would like to be discussed during your event. If you select other, please provide the topic in the following box.
*
Good Listener Techniques.
15 Laws of Success.
Real Estate.
Self-improvement.
Healing through Movement and Dance.
Relationships.
Spiritual Life.
Mental Health.
Teen World.
Financial Health.
Business and Career
Social Wellness
Other
Additional Relevant Information or Requests
Submit
Should be Empty: