Booking Request
Thank you for considering our pastors for your upcoming event. Please complete and a member of team will review and respond within 48 hours of receipt.
Who are you inviting to speak?
*
Pastor Dr. Darlene Allen Nichols, PhD
Pastor Eugene Nichols, Jr
Your Name
*
First Name
Last Name
Your Contact Email
*
example@example.com
Your Contact Phone Number
-
Area Code
Phone Number
Name of Organization
*
Name of CEO/Pastor
Organization Website
*
Name of Event, Conference, Service, etc.
*
Specific Request
Keynote Speaker
Session Facilitator
Guest Lecturer
Guest Panelist
Panel Session Facilitator
Mistress of Ceremony
Leadership Seminar
Group Counseling Session (Illinois only)
Date of Event
*
/
Month
/
Day
Year
Date
Time
AM
PM
Time of event
Expected Number of Attendees
*
Event Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is travel Required?
YES
NO
Will There be a vender table available?
*
Yes
No
Will There be a Volunteer Available to Run the Resource Table?
*
Yes, we will have a volunteer available.
No, the Pastor's team will need to provide someone to run their resource table.
Theme(s) and/or Focus of event
Additional Relevant Information or Requests
Submit
Should be Empty: