Speaking Request Form

First Name

Last Name

Name of Church/Company/Event

Info About Church/Company/Event

Start Date * required

End Date * required

What time(s) are you requesting James to speak?

Is there a theme or suggested speaking topic?

What is the approximate length of time allotted to speak?

Will you be able to accommodate 1–2 guests with James? *

Yes

No

What is the name of the venue?

What is the venue location?

If the venue is a church, please list the name of the pastor.

What is the expected size of the audience?

Give us a brief description of the event and organization.

Provide the name of Contact Person

Contact Person's phone number

Contact Person's email address

What is the preferred method of contact? *

Phone

Email

When is the best time to contact?

What is the honorarium budget?

Will you advertise this event online (website, social media, etc.)? *

Yes

No

Will advertisements for this event be broadcasted on any other public media? *

Yes

No

Will this event stream live online? *

Yes

No

If being streamed live, on what website?

What is your organization's website?

Do you have any additional questions or comments?

Thanks for submitting your request!

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