Book Pastor Dr. Derrick D. Jordan Questionnaire  
You have requested to book Pastor Dr. Derrick D. Jordan. We appreciate your interest! Please answer the the following questions so that someone from our office can contact you to see if we can approve your request.
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Email *
Contact Person *
Contact Email *
Contact Phone Number *
Event Purpose *
Event Date *
Event Location *
What type of speaking engagement is this: keynote, training, conference workshop, private business seminar, etc. *
Which topic would you like him to speak on? *
Would you like him to participate in any other event activities, such as meet & greet, panels, luncheons, etc. *
How many people are expected to attend this event? *
What is the nearest airport? *
Will ground transportation be provided? *
What is the budget for a speaker? *
Is travel and lodging included for the speaker? *
Is travel and lodging included for the speaker's assistant? *
How long do you desire him to speak? *
Special Request or Needs: *
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