Gerald Benton Booking Request Form
Ministry/Organization Name
*
Ministry/Organization Website
*
Minstry/Organization Email
*
Primary Contact Name
*
Primary Contact Email
*
Primary Contact Phone
*
Event Information
Event Type
*
Please Select
In- Person
Virtual
In-Person & Virtual
Type of Presentation /Appearance:
*
Please Select
Ministry
Conference
Book Signing
Podcast Guest/Radio Guest
Crusade
Workshop
Retreat
Event Name and Theme
*
Event Street Address (include city, state and zip code
*
Event Start Date- Finish Date
*
Event Starting Time
*
Hour Minutes
AM
PM
AM/PM Option
Event Finish Time
*
Hour Minutes
AM
PM
AM/PM Option
If you are requesting our attendance at a conference, workshop or retreat, we would like to know what did God say to you about our being there?
*
What is it that you feel we might be able to do for the people in attendance?
*
Do you believe in the following: (please check all that apply)
Rows
Column 1
Speaking in tongues
Laying on of hands
Deliverance, with possible manifestation of demons
Anointing others with oil
Suggested Topic
*
Speaking Date, Time and Duration
*
What type of advertising will you do? (check all that apply)
Rows
Column 1
Social Media
Radio
Television
Text Blast
Physical Flyer Handous
Newspaper
Any special events following the main event?
*
Expected Number of Attendees?
*
Target Demographics of Audience (please check all that apply)
Married
Unmarried
Men
Women
Youth
Will there be display table(s) available to sell merchandise? If so, what size and do you have someone to work the table(s)?
*
Travel & Hotel
Will there be a driver provided to and from the event?
*
Audio/Video
Will the service(s) be video-recorded?
*
yes
No
Will the service(s) be audio-recorded
*
yes
no
Can you provide copies of audio/video master tapes following the service?
*
yes
no
Submit
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