Speaking Request Form General Information Host / Organization * Address of Event * Address 1 Address 2 City State/Province Zip/Postal Code Country Start Date of Event * MM DD YYYY End Date of Event MM DD YYYY Host Information Host's Name * First Name Last Name Title of Host * Host's Email * Host's Mobile Phone * Country (###) ### #### Administrative Assistant Information Administrative Assistant's Name First Name Last Name Administrative Assistant's Email Administrative Assistant's Mobile Phone Country (###) ### #### Event Information What type of event is this? (Sunday morning, Youth service, Youth convention, Leadership training, School Assembly, etc.) Anticipated Attendance * Age Range of event * Number of times Tim will be speaking * 1 2 3 or more Evant Times * Include the start time of the session and the approximate time Tim will be speaking. Nature and length of each session * (Sermon, leadership training) Topic you would like Tim to speak on: * Is there a theme or inspiration behind the event? * If so, please elaborate below. Transportation and Accommodation Will you be booking Tim's flights and hotel? * Yes No Does your budget allow for a travel companion? * Media/Content Creator Yes No What are the hotel accommodations? * What is the nearest airport to your event? * Honorarium Details What is the anticipated honorarium? * Please be aware that travel expenses are not included in the honorarium. $ Thank you for inviting Tim to be part of what God is doing in your church or event. We’ve received your request and will be in touch soon. We’re praying with you for life-change, breakthrough, and impact wherever God opens the door.