Speaker Request Form

If you are a human and are seeing this field, please leave it blank.

Fields marked with a * are required

Organization Information

Name of Organization *

Address 1 *

Address 2

City *

Zip / Post Code *

Website

Contact Information

Contact's Name *

Contact's Title

Contact's Home Phone

Contact's Cell Phone

Contact's Email *

Event Information

Type of Event

Expected Attendance

Date Requested

Time of Event

Type of Presentation Requested:

Sermon

Keynote

Workshop

Seminar

Other

What is the theme of your event? (List any specific topics that you would like Minister Macklin to address)

Alloted Time for Presentation

Will There Be Other Speakers on the Date Requested?

Is the Event Open to the Public?

Please Provide the Amount of Any Offered Honorarium:

32 + 1 = *

More Info

For more information regarding our services, please complete and submit the form on this page. We will contact you within 48 hours. Thank you! Address: Washington, DC Phone: 240-257-2794

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