Speaker Request Form CONTACT INFO Full Name * First Name Last Name Email * Name of Church or Organization * Website or Social Media EVENT DETAILS Type of Event (Conference, Weekend Services, Training Courses, Retreat, Other) * Event Dates (Start and End) * Location (Venue Name, Address, City, State, Zip) * Target Audience (Church Leaders, General Congregation, Men, Women, Youth, etc.) * Name of the Event Estimated Attendance Event Schedule or Draft Agenda (Upload or Describe) SPEAKER REQUEST Who are you inviting? * Greg Miller Lucy Miller What are you requesting from the speaker(s)? * Preaching Prophetic Ministry Training Courses Personal Ministry Sessions Other (please describe) How many sessions are you requesting? * Preferred session topics or themes HOST INFO Name and Title of Main Contact Person * Relationship to the Church/Organization * Phone Number * Country (###) ### #### Will you cover travel, lodging, and meals for the speaker(s)? * Yes No Explain FINAL DETAILS How did you hear about WINS? * Referral Social Media Conference Training Other (please describe) Is there anything else we should know before considering your request? Thank you!
