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Speaking Engagement Form

Thank you for considering me for your event. Please complete this form with as much detail as possible, and I’ll get back to you shortly to confirm availability.

Section 1 - Contact Details

Full Names

Organization / Church / School / Company Name

Position / Role

Email

Phone

Section 2 - Event Information

Event Name/ Title

Event Date(s)

Event Time(s)

Location (Venue name, City, Country, or Virtual)

Is this an in-person or virtual event?

Is this an in-person or virtual event?
A
B
C

Expected Audience Size

Audience Type

Audience Type
A
B
C
D
E

Section 3 - Speaking Request Details

What Topic(s) would you like me to speak or focus on?

How long would you like me to speak?

How long would you like me to speak?
A
B
C
D
E

Format of session

Format of session
A
B
C
D
E
F
G

What is the theme or purpose of your event?

Are there other speakers at this event?

Section 4 - Logistics

For business, corporate, and academic events, my speaking engagements are subject to a speaker fee/honorarium.
For church and ministry events, I do not charge a fee, but I kindly ask that travel and accommodation expenses be covered.

Do you have a budget for this event?

Do you have a budget for this event?
A
B
C

Will travel and accommodation (if required) be provided?

Section 5 - Additional Information

How did you hear about me?

Point of contact on the day of the event

Any other details you’d like me to know?

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