Speaker Request Form

Name

First Name

Last Name

Your Position or Title

Organization Name

Website

http://

Phone

(###)

###

####

Can we text you?

Sure!

No Thanks

Do you have pastoral and/or board support for your request?

Yes

Start Date

YYYY

End Date

YYYY

Type of Engagment

Event Location

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What are the primary goals or objectives you aim to achieve with this event?

Will this be a one day event or will it span multiple days?

How many speaking sessions is Pace expected to conduct each day?

How would you describe the demographics of the expected audience?

ex: Youth (13-18), Professionals, Adventists, Non-Adventists, students, etc

Anything else you would like to tell us?

Would you like to order copies of Just Jesus or Intentional Influence to supplement the event?

Yes

Not this time

Thank you for filling out the form! I am truly honored and appreciative of all requests to minister with you. While each request is prayerfully considered, unfortunately, I am unable to fulfill each one. If I cannot make it, I may be able to recommend colleagues that may be suitable options - Pace