top of page

SPEAKING ENGAGEMENT REQUEST FORM


Thank you for your interest in inviting our representative/speaker to participate in your event. Please complete the form below to help us review your request and respond promptly.

SECTION 1: EVENT INFORMATION

Event Type
Conference
Worship Service
Workshop
Seminar
Community Event
Other
Start Date and Begining Time of Event
Month
Day
Year
Time
HoursMinutes
End Date and time the event is ending
Month
Day
Year
Time
HoursMinutes
Event Location

SECTION 2: HOST ORGANIZATION / CONTACT INFORMATION


SECTION 3: SPEAKING REQUEST DETAILS


Role Requested
Keynote Speaker
Preacher
Panelist
Worshop Leader
Special Guest

SECTION 4: LOGISTICS & ARRANGEMENTS


Will honorarium or love offering be provided?
Yes
No
Will travel and accommodations be covered?
Yes
No

Please note that any travel arrangements made must be made for the speaker and 1 companion

Audio/Visual Equipment Available
Yes
No

(Please allow up to 10 business days for review. A representative will contact you to confirm availability and next steps.)

Approval

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

© 2025 Reverend Dr. Terry Lee Minisistries

CCN

bottom of page