Pastor Jeff Leake - Speaking Information Form
Lead Pastor, Allison Park Church, 2326 Duncan Ave, Allison Park, PA 15101
Email address *
THANK YOU
Thank you for inviting Pastor Jeff Leake to speak at your event. His desire is to serve you with excellence and to be properly prepared to ensure a great impact. If you would please fill out the information below that would be greatly appreciated.
HOST INFORMATION
Name of Church or Organization *
Your answer
Address of Church or Organization *
Your answer
Website of Church or Organization
Your answer
Name of Leader of the Church or Event *
Your answer
Leader's Contact Information *
Please include cell phone & e-mail address (In the event contact is needed during non-office hours)
Your answer
Coordinator's Contact Information *
Please include name, office phone, cell phone & e-mail address (In the event contact is needed during non-office hours.
Your answer
EVENT INFORMATION
Date(s) of the Event *
Your answer
Event Location
(if different than host location)
Your answer
Event Start Time *
Your answer
Event End Time *
Your answer
Time Pastor Jeff Should Arrive for Event
Your answer
Event Agenda/Schedule *
Your answer
Duration of Speaking Times for Pastor Jeff *
If more than one session, please indicate # of sessions and length of each one.
Your answer
Event Topic or Theme
Topic(s) Pastor Jeff you would like him to be speaking on.
Your answer
Event Attire
Your answer
Media Capabilities
TRAVEL INFORMATION
Unless prior arrangements have been made, Pastor Jeff's office will book his airline and hotel travel. An invoice will be provided for reimbursement to include these costs.
Closest Commercial Airport
If travel by air is necessary
Your answer
Transportation
If Pastor Jeff is not driving his own vehicle to the event.
Driver Information
If host is providing transportation, please provide name and cell phone of driver.
Your answer
SPEAKER'S PREFERENCES
We've provided this information below for your convenience, but these preferences are not required in any way.
Meals/Snacks:
Healthy, protein bars, granola bars, almonds, Greek yogurt, fresh fruits
Restaurant Preference: Any place where he is able to get things like grilled chicken or fish, vegetables and a salad.
Drinks:
Water (prefers chilled), coffee - dark roast if possible with one cream.
Microphone:
Pastor Jeff prefers to have a handheld mic, but if not available, he is flexible with what is provided.
Resource Table
Pastor Jeff has written the books "God In Motion", "Praying with Confidence", and "Power for Life".
Would you be willing to have him bring copies to sell?
Would you be able to provide someone to man the resource table?
FINANCIAL INFORMATION
Travel Expenses:
Travel expenses (if incurred) can be reimbursed to Allison Park Church, 2326 Duncan Avenue, Allison Park, PA 15101 Attn: Matt Smith - Please write in the memo the name of your church.
Honorarium
Please make out to Jeffrey S. Leake
W-9
Can be provided upon request
Is there a flat travel reimbursement you will cover? If yes, please indicate the amount. If no, please indicate what you are able to cover. *
Your answer
THANK YOU
I appreciate you providing this information. If you have any questions or need to contact me, you can reach me at 207-852-7890 or matts@allisonparkchurch.com. Any additional comments you may have please provide below. Thank you, Matt Smith
Your answer
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