Speaking Requests Please complete the form below and we will get back to you as soon as possible. Point of Contact Name * First Name Last Name Point of Contact Email * Point of Contact Phone * (###) ### #### Name of Event * Name of the Organization / Company / Church affiliated with the event * Website for the Church / Company / Event * http:// Type of Event * Conference Church Service Youth Service Podcast / Interview Other Start Date * MM DD YYYY End Date * MM DD YYYY What time(s) are you requesting Pastor Andre to speak? * What is the approximate length of time allotted to speak? * Is there a theme or suggested speaking topic? * Honorarium Amount * Please note that we do not ask for nor do we require an honorarium minimum. We will not reject a speaking engagement based on any given honorarium amount. Name of Venue * Venue Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Expected Size of Audience * Audience Demographic * How did you hear about Pastor Andre? * Do you have any questions or comments to add? Thank you for submitting! We will get back with you as soon as possible.
