Tanda Canion. Ministry Request Form -Local

Ministry Request Form (Local)

Please fill out this form completely. Incomplete information will delay processing. Form will not be submitted without required information. If item does not apply, please skip to the next item.
Church Information

Please provide information regarding your ministry
Please check appropriate box: *

New Fellowship Former Fellowship
If New Fellowship, who do we have to thank for the referral? *
Church/ Organization Name *
Pastor/ Organization Director *

Prefix First Name Last Name
Church Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Church Fax

Area Code Phone Number
Church Phone *

Area Code Phone Number
Contact Information

Please provide contact information
Full Name *

Prefix First Name Last Name
E-mail *
Phone Number *

Area Code Phone Number
Alternate Contact Name

First Name Last Name
Alternate Contact Email
Alternate Contact Phone Number

Area Code Phone Number
The Service

Please provide details about the service
Please give the ministry dates (Include day(s) and time(s) for example Monday, April 12, 2011 at 7:00pm) *
Type of Service *
Theme
Please list any additional speakers.
Please provide expected attendees. (This will allow us to properly prepare our ministry product). *
Special attire/color requested? If so, please describe. *
Is the service for: *

Men only Women only Both Other
If other, Please Specify
Location of Service *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Please note: If the speaker is required to travel by car for 1.5 hours or more, speaker request that host ministry provide a rental car plus gas allotment. Airline ticket might be required.
Please specify rental car information and amount for gas allotment (if applicable).
Honorarium

*Please provide details about the speakers honorarium to avoid any miscommunication or division as stated in

I Corinthian 1:10
Is the honorarium percentage or set amount? (Additional Offering will not be raised if specific honorarium is established unless previously arranged.) Please specify Percentage or amount *
Would your ministry like for Dr. Canion to raise the offering? *

Yes (Please review previous information) No Undecided
Ministry Resources

Ministry Resources
Can ministry provide a 6 or 8 foot table(s) in the main flow of traffic to display Dr. Canion's ministry resources? *
If Dr. Canion's adjutants are not present, can ministry appoint 2 people to be responsible for resources? *
Would it be possible if Dr. Canion could receive a CD/DVD of message after the service?
Enter the text you see on the right. *
Should be Empty:

Church Information

Contact Information

The Service

Ministry Resources