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Invite Jeremiah
Name Of Orginization Or Church
*
Name Of Person Inviting Jeremiah
*
City & State
*
Primary Contact Name
*
Primary Contact Number
*
What is the Primary Contact's Position/Title
*
Email
Instagram Handle Of Organization/Person/Podcast
*
Speaking Date and time
*
Month
Day
Year
Time
:
Hours
Minutes
AM
Alternative Date Option If Original Date Not Open (LEAVE BLANK IF NA)
Month
Day
Year
Time
:
Hours
Minutes
AM
Event Type
Conference
Weekend Main Service
Young Adult Service
Youth Service
Leadership
Camp
Podcast
Other
Anticipated size of audience
*
How Many Times Will Jeremiah Be Preaching/Speaking?
*
Jeremiah will likley travel with someone for engagements. Can airfare be provided for both Jeremiah and assistant?
Yes
No
Will Jeremiah Preach with an Interpreter?
*
What Airport will Jeremiah Fly In And Out Of?
*
What kind of overnight accommodations will be made?
*
Will his session be recorded? (audio and video)
Yes
No
Maybe
Budgeted honorarium for speaker (USD)
Would Jeremiah be allowed to sell his book/Merch at this event?
How did you hear about Jeremiah?
Anything else you would like Jeremiah to know?
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