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Speaker Request Form
Please provide the following information about the speaker. If payment for the speaker has been discussed, please fill out the W2 at the bottom of the page.
Committee Overseeing Event
Adult Education
Children & Youth
Fellowship
Finance
Matthew 25
Mission
New Members
Property
Staff Resources
Stephen Ministers
Stewardship
Women's Association
Worship & Music
Committee Contact Person
First Name
Last Name
Title of Presentation
Date(s) of Event
Speaker's Information
First Name
Last Name
Email
Phone Number
Address
Apartment, suite, etc.
City
State
Zip/Postal Code
Speaker's Biography
Description of Presentation
Select All Equipment Needed
Podium
Screen/Computer Projection
Microphone
Flip Chart with Markers
Bibles
Hymnals
White Board with Markers
TV/DVD Player
Computer (Windows OS)
Computer (Mac OS)
None
Honorarium Payable To
Please share any additional information about your event
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