Faith Deliverance Request Form

Request for the ministry of the pastor, elder, minister, evangelist, mother, missionary, or other.

Today's Date: *

Church Name: *

Church Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Name of Church Auxiliary making request: *

Contact person name and position: *

Contact Phone Number:

Email of contact person: *

Contact Fax number:

Date(s) of request:

Time your event starts: *

Name of the person you are requesting to speak: *

Purpose of event, theme, and scripture: *

Host Pastor's name: *

Has your Pastor granted specific approval for this speaker? *

What exactly do you want the speaker to do? *

Are there other speakers on the same program? *

Are you requesting participation from our church to attend? *

What honorarium are you preparing to give? *

Captcha *

Phone

Thank you for your interest in Faith Deliverance Apostolic Church.