Speaker Request Formafter consulting brian’s current speaking schedule Please complete the form below Name * First Name Last Name Role * Email * Phone * (###) ### #### Church/Ministry Name * Where will the event be held? * Date of the event * If spanning multiple days please indicate in the notes section MM DD YYYY How many attendees do you anticipate? * Attendees will consist of... * Ministry Leaders Pastors Deacons Lay-Leaders Members Would you allow PS to exhibit and sell resources at your event? * YES NO Are you willing to cover Brian's honorarium? * Honorarium for weekend event and preaching is set at $1000 by the PS board. If you are unable to do this please answer no and explain in the notes. Inability to supply full honorarium does not mean that Brian will reject speaking at your event. YES NO MAYBE Are you willing to cover Brian's travel? * YES NO Additional Notes: * Provide any additional notes that would be helpful for our team in discussing this engagement. Thank you for completing this speaking request form. We discuss these requests regularly but usually it will take 2-4 weeks for our team to follow up with next steps. Look forward to serving your group in this way!-PS Team