Speaking Engagement Inquiry Form

Contact Person's Name*

First NameLast Name

Title of Event and Name of Host Organization*

Contact Person's Number*

Area CodePhone Number

Contact Person's E-mail*

example@example.com

Host Organization's Website or Facebook Page*

Host Organization's Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Speaking Topic or Theme*

If you chose Other Workshop or Conference Speaker, please indicate Topic or Theme, also include any scriptures. Be detailed as possible:

What is the nature of this event?*

Date of Event*

MonthDayYear

Time*

:HourMinutesAM/PM Option

Location of the Event (Venue Name, Address, City, State, Zip Code)*

Length of presentation time:*

Will there be other speakers/presenters?*

YesNo

Estimated Audience size:*

Is there an admission fee?*

YesNo

A/V equipment available (if applicable)?*

Do you have professional sound and/or video technicians available?*

If you are recording this event, will you provide us a copy of the recording for our unrestricted use? *

Is there WiFi available?*

YesNoN/A

Will there be a vendor table available for book/product sales? *

If the event requires travel outside of my current city or state, the Host Organization will be responsible for travel and hotel fees (if applicable), in addition to the any speaker fee. Please let us know ASAP if your budget can handle these expenses. All fees are negotiable.*

How will you promote and market this event? Please email any marketing materials if my image or likeness will be used.*