Name of Pastor/Ministry Head/Business Leader:
Church/Organization's Name:
Street Address:
City:
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Zip/Postal Code
Business Phone
Business Fax
E-mail
Website address
Office Hours
Contact Person
Contact Cell
Date of Event
Time of Event
Location of Event
Type of Financial Remuneration to Speaker?:	free will offering set amount
**"If set amount, what is your speaker budget?”
What is the format?:	sermon/preaching conference/teaching
Will event be recorded? :	Yes No
Theme or Purpose:
Handouts - can you make adequate copies? :	Yes No
Handouts - can you make adequate copies? :	Yes No
Is there a letter or brochure? :	Yes No
If so, can you send us a copy?:	Yes No
Are we allowed to sell resources?:	Yes No
Is there a visible, high traffic area with 2 eight foot tables for the sale of resources?:	Yes No
Schedule of speaking time(s) for Dr. Chand (please include time allocated):
Are there other speakers?:	Yes No
If so, who are they and what are they doing?:
Who is expected to attend? - The demographics:
How many people are expected to attend?:
Questions/Comments?:
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