Ministry/Church name:

Contact name:

Email address:

Website:

Phone number:

Fax number:

Address:

City:

State:

ZIP:

Denomination or ministry
association (if applicable):

Event Information:

Event location:

Nature/Type of event:

Event theme/topic:

Projected attendance:

Other confirmed speakers:

Event dates:

Average meetings per day:

Yes No ---- May we display and sell our products?

Yes No ---- Will other congregations be involved?

Yes No ---- May we bring our own ministry team?

Yes No ---- Can housing be provided for the ministry team?