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Speaker Request Form
Have you spoken at Charity Chapel before?
*
Yes - I am a returning speaker
No - This would be my first time speaking at Charity Chapel
Name
*
Organization/Ministry/Church
*
Phone
*
Email
*
What type of speaking request are you submitting?
*
Missionary presentation (table in lobby, video, etc)
Guest speaker (sermon)
Special service or event
Ministry update (no more than 10 minutes total)
Other
What is your relationship to Charity Chapel?
*
Member/regular attender
Missionary supported by Charity Chapel
Missionary not currently supported by Charity Chapel
Pastor/church leader
Community member
Other
What type of organization or ministry are you representing?
*
I am representing a church
I am representing a missions organization
I am representing a nonprofit/ministry
I am speaking independently
Other
What is your current role?
*
What would you like to speak about?
*
Missions
Evangelism
Personal testimony
Ministry update
Specific ministry/project
Other
Proposed title/topic
*
Please briefly describe what you would like to share.
*
How long would you expect your presentation/message to be? (include length of video, if you intend to use one.)
*
5-10 minutes
10-20 minutes
20-30 minutes
30-45 minutes
45-60 minutes
More than 60 minutes
I'm flexible
Date requesting to speak
*
If you need something else, please let us know...
Submit
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