Information Needed:

ORGANIZATION NAME*

Contact Person:

FIRST & LAST NAME*

POSITION*

PHONE*

EMAIL*

WEBSITE*

Host Organization / Ministry Information:

ORGANIZATION NAME*

SENIOR LEADER / PASTOR (For speaking engagements)

WORSHIP LEADER / PASTOR (For worship engagements)

Event Information:

DATES

Month Day Year

# OF DAYS

EVENT LOCATION*

EVENT CITY*

EVENT PROVINCE / STATE*

TYPE/NATURE OF EVENT

OTHER CONFIRMED SPEAKERS

EXPECTED # OF ATTENDEES

MISC Information:

WOULD YOUR BUDGET COVER SOMEONE TRAVELING WITH EMMANUEL & EMILY?*

WHEN WILL YOU NEED TO KNOW IF THEY WILL BE ABLE TO COME?*

HOW DID YOUR HEAR ABOUT STANDING FOR LIFE?*

ARE THERE ANY OTHER DETAILS YOU THINK WE SHOULD KNOW?