PJR Ministry Request Form

PJR Ministry Request Form

Please complete the form below to request engagements.
Organization Name*

NameName
Primary Contact Name*

First NameLast Name
Primary Contact E-mail*
example@example.com
Primary Contact Phone Number*
Event Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Theme/What type of event is this?*
Please list the type of ministry you would like (preaching, teaching, prophetic ministry, leadership development).*

PreachingTeachingProphetic MinistryLeadership Development
Is there specific attire? Please select all that apply.*

Clergy/Civic AttireChoir DressBusinessBusiness CasualCasualNot Specific
What date(s) is your event?*

DayMonthYear
What time does the event start?*

Hour Minutes

AM/PM Option
What is the expected attendance? *
What is the budgeted honorarium for this event? *
Will lodging be provided for this event? *
Will there be a table available for products? *
Will travel be provided for this event? *
Please list any additional information that would help us to consider the event and prepare for you.
Should be Empty: