Pastor Mike, Jr. Ministry Request Form

General Information

This section will allow you to provide us with some general information about yourself or your organization.
Name of Sponsoring Church / Organization / Individual*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Physical Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Website
Please list your website, leave blank if unavailable.
Social Media Platforms
Please provide the social media platform and the user name. (For example, Instagram - @iguser)
YesNo

Pastoral Information

Please provide the information requested in case Pastor Mike, Jr. would like to reach out to your Pastor directly.
Pastor's Name

First NameLast Name
Cell Phone Number
Please provide your pastor's direct contact number.Format: (000) 000-0000.
Pastor's Email Address
Please provide your pastor's email address.

Event Information and Details

Please provide as much information as possible for each question.
Name of Event/Occasion*
Please provide a brief description of your event/occasion. *
Event Contact Name*

First NameLast Name
Event Contact Cell Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Event Contact Email Address*
example@example.com
Event Date*

MonthDayYear
Date
Event Time

Hour Minutes

AM/PM Option
Alternate or Additional Dates
Please let us know if this is a multi-day event or if there is a second choice date if your requested date is unavailable.
Event Venue
Please include the name of the venue and the address.
IndoorOutdoor
ClergyGeneral MembershipLeadersYouthOther
Preferred Attire for the Event
If you selected OTHER for attire, please explain.
Expect Attendance
Please be honest and realistic with your number.
Preached WordMusic Ministry

Music Ministry
Please provide the number of tracks or amount of time requested for ministry.*
Instrumentation Requested*
What is your budget for Pastor Mike, Jr.?*
Please specify if this is all inclusive.
Should be Empty:

General Information