Speaker Request Form

In order to request one of our speakers for your event, please completely fill out the scheduling form below and submit it. We will get in touch with you as soon as we have an answer to your request.

What's the name of your organization, church, or school?*:
Address*:
City, State*:
Zipcode*:
Phone*:
Contact Name*:
Email Address*:
List specific or possible dates for the event*:
Location of the event*:
Have you held this event before? If so, what was the attendance?* Yes   No
Enter Attentdance*:
What is this year's expected
attendance?*:
Please indicate specific emphasis. Multiple selections can be made: Mac, command click, Windows, control click. If other, please specify.*:
Other
Is this event denominational?*: Yes   No
What is the budget for the speaker?*: $
Can you receive a love offering?*: Yes   No
Can you cover all expenses, including roundtrip airfare or mileage depending on location, hotels, meals?*: Yes   No
  If no, explain:
Who will lead worship?*:
We have several praise and worship leaders if you are interesed?*: Yes   No
Indicate which Speaker you would like to schedule: Mac, command click, Windows, control click.*:
How did you hear about the speaker you have requested, and have you previously heard him?*:
What date do you need to hear from us? (Please allow up to two weeks for a response)*:
Indicate which promotional materials you need. Multiple selections can be made: Mac, command click, Windows, control click.*:
Please take a moment to share anything about the event with us. This helps us as we pray for the Lord's guidance. Share your vision, goals, the history behind the event and anything you would like us to know.*:
 
 
Crossroads Worldwide
307-A East College Avenue
Shelby, NC 28152
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