Speaking Request Form. HOST CONTACT INFO Name of the Host * First Name Last Name Host Phone * (###) ### #### Host Email * What church, ministry, or organization do you represent? * EVENT DETAILS What is the name of the Event? * What is the date of the Event * Start date of event MM DD YYYY Event Address * Address 1 Address 2 City State/Province Zip/Postal Code Country What type of event is this? * Church service, conference, youth conference, leader training,.. What is the Event Schedule? * When will Pastor Brent be speaking? How many people do you expect to attend? * ACCOMMODATION AND TRANSPORTATION Are you willing to provide air transportation for Brent and a traveling companion (accountability / prayer partner)? * Yes, for Brent and one other No, for Brent only No, we do not have a transportation budget Are you willing to provide hotel accommodation for Brent (and companion if applicable)? * Yes No We prefer to make travel arrangements for Brent. Are you willing to reimburse expenses if receipts are provided? * Yes, we can reimburse No, we'd prefer to make arrangements HONORARIUM DETAILS What is your honorarium budget? * Please know that we are understanding of budgetary restrictions and are always willing to make things work. Is there anything else you would like Brent to know about this event? Thank you for reaching out! Looking forward to talking with you.