Prophetess Stephanie Williams
Speaker Request Form
Host Name
*
First Name
Last Name
Host Contact Email
*
example@example.com
Host Contact Phone Number
*
Format: (000) 000-0000.
Name of Church or Ministry
*
Name of Requested Event or Conference
*
Theme(s) and/or Focus of Gathering
Date of Event
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Event Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Will an Honorarium be Provided? (NOTE: Honorarium details will be discussed prior to acceptance. Stephanie Williams’ heart is to serve; but clarity helps ensure smooth planning for all parties.)
*
Yes
No
What honorarium amount has been budgeted for this engagement?
*
Will Hotel and Flight Expenses be included? (Note: Flight expenses are only required if church or venue is more than three hours away. Only Hotel expenses are required if venue is at least 2 hours away).
*
Yes
No
Hotel Only
Doesn’t Apply
Will There be a Resource Table Available for Prophetess to sell her books?
*
Yes
No
Additional Remarks:
Submit
Should be Empty: