Speaking Request

Speaking Request
Church/Organization Name*
Website*
Contact Person*
Contact Phone
Format: (000) 000-0000.
Where is the event located?*

In StateOut of State
Address of Event*
City*
State*
Zip*
Contact Email*
example@example.com
Event Details
Please give a brief description of your event*
Date of Event*

MonthDayYear
Date
Times of Event (Start & End)*
Expected Attendance*
Please enter a number 1 to 10,000
Audience Demographic
Who is the target audience?*
Pastor's, Students, Men's Group, etc
How many times would you like Dr. Garcia to speak?*
What time does Pastor Noe need to be at location?

Hour Minutes

AM/PM Option
How long would you like Dr. Garcia to speak?*

Hour Minutes

AM/PM Option
When is the first day Dr. Garcia would be speaking?*

MonthDayYear
Date
When is the last day Dr. Garcia would be speaking?*

MonthDayYear
Date
Is there a particular topic or text you would like Dr. Garcia to address?*
Are there any other additional requests?*

NoneMeetingsBreak Out SessionsInterviewsSocial CommitmentsOther
Travel
Will you be covering travel expenses (airfare, lodging, meals, and rental car) for Dr. Garcia?*

YesNo
Due to Pastor Noe's commitment to his family, he sometimes uses travel time as an opportunity to enjoy his family. Will you cover travel for his wife? If a camp, can his family join him?*

YesNo
Closest Airport*
Recommended Hotel(s)*
Other Details
Pastor Noe prefers to teach off an Apple iPad- is that possible to connect an iPad to your system/screens?*

YesNo
Tech Contact Information
Sermon Notes/Presentation/Slide Due Date*

MonthDayYear
Date
Recommended Dress Code*
What does your budget allow for an honorarium? (Please don't leave blank)*
Additional Comments/Notes
Should be Empty:

Speaking Request

Event Details

Travel

Other Details