HIM Speaker Request Form

Hope International Ministries Request Dr. Hope Eady Form

PLEASE COMPLETE THIS FORM TO REQUEST DR. HOPE EADY AS

A SPEAKER FOR YOUR UPCOMING EVENT.
Name*

First NameLast Name
Contact Email*
example@example.com
Contact Phone*
Church/Organization*
Senior Leader's Name:
Address 1*
Address 2
City*
State/Province*
Zip/Postal Code*
Country*
How long has your church/ministry been serving your community?*
Organization Website*
Social Media URLs Facebook, Twitter, etc
Event Information
Event Name (if applicable)
Event Description*
Location of Meeting (If Different from Ministry)
Address 1
Address 2
City
State/Province
Zip/Postal Code
Event Start Date*

MonthDayYear
Date
Event End Date*

MonthDayYear
Date
Service Time(s) - Please include time zone*
Event Website
Type of Engagement*

ConferenceChurch ServiceWorkshop/SeminarRetreatOther
If Other, Please Specify
Approximate Event Attendance (How many people are you expecting to attend?)*
Other guest speaker(s) ministry date(s) & time(s)
Event Budget
Is there a registration fee for this event?*

YesNo
Are you receiving love offerings?*

YesNo
What is the amount you have budgeted for Dr. Hope (excluding travel expenses)?*
Products
Is the sale of ministry product permissible?*

YesNo
Are you able to provide at least one (1) 8 ft table to display and sell ministry products?*

YesNo
Media Services

Please provide HIM with a complimentary video and/or audio of the service(s) if possible, along with any digital photos taken.
Will the service(s) be video recorded?*

YesNo
Audio Recorded*

YesNo
Will the service(s) be live webcast?*

YesNo
so, please list site:
Additional Information:
Should be Empty:

Event Information

Event Budget

Products

Media Services