Speaker Request Form

Pastor Smith's Speaker Request Form

If you'd like to book Pastor Smith for you upcoming service, conference or event, please fill out the form below and someone from our staff will contact you as soon as possible.
Name of Church, Ministry or Organization
Church, Ministry or Organization Website
Pastor or Leader's Name

First NameLast Name
Pastor or Leader's Contact #

Area CodePhone Number
Pastor or Leader's Email
example@example.com
Date of Service/Event

MonthDayYear
Date
Alternative Date of Service/Event

MonthDayYear
Date
Time of Service/Event

:HourMinutesAM/PM Option
Address of Event, Service or Conference

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Service, Event or Conference
Theme(s) and/or Focus of Gathering
Contact Person Name

First NameLast Name
Contact Person Phone Number

Area CodePhone Number
Contact Person Email
example@example.com
Is Pastor Smith be permitted to sell ministry products (Books, tshirts)? (If yes, a small table where most people will be exiting will need to be provided)
Do you have a cordless microphone?
Do you have musical instruments (ie drums, keyboard, organ)?
The following questions will help us ensure that we operate in decency and in order when ministering at your church or ministry. We believe in following the beliefs, customs, and traditions of the ministry that we are invited to minister, if we accept the engagement request.
Does the ministry believe in the operation of the gifts of the spirit (tongues, laying of hands, and prophesy), please mark "no" if yes to all is not true?
Does the ministry believe in women preachers?
Does the ministry believe in women wearing pants and/or makeup?
Ministry Denomination | Affiliation
Time Allotted for Speaker to Speak/Minister
Dress Code
Please provide any additional information that you think we would need to be made aware of before ministering at your church:
We request that all travel expenses for Pastor Smith be covered and booked by the hosting ministry/organization (if applicable). Please initial if you agree.
Should be Empty:

Pastor Smith's Speaker Request Form