JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Speaking Request Form - In Person
Thank you for considering Mekdes to come speak at your event. O
nce you complete this form, we will be in touch regarding Mekdes' potential availability and participation.
* Indicates required question
Email
*
Record my email address with my response
EVENT DETAILS
Event Name
*
Your answer
Church/Organization Hosting this Event
*
Your answer
Event Website
*
Your answer
Event Address
*
Your answer
Type of Event
*
Conference/Summit
Retreat
Workshop/ Class Room
Other
Event Date Start
*
MM
/
DD
/
YYYY
Event Date End
*
MM
/
DD
/
YYYY
Preferred Subject topic or theme you want Mekdes to speak on
*
Your answer
How many session would you like Mekdes to Speak in?
*
Your answer
How many people do you expect to attend?
*
Your answer
Honorarium amount budgeted?
*
Your answer
Does your budget cover transportation, lodging and meals?
*
Yes
No
Would there be interest in purchasing Mekdes' book "A Just Mission" to sell during or after the event?
If Yes, please let us know how many you'd like to purchase and we'll put in the order for you.
*
Yes
No
Other:
CONTACT INFORMATION
Contact Full Name
*
Your answer
Cell Number
*
Your answer
Email
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report