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Host Ministry Information

Sponsor / Host of Event

Name of Organization

Street Address

Street Address 2

City

State/Province

Zip/Postal Code

Country

Location of Meeting (If Different from Ministry)

Lead Pastor(s) Name (If Applicable)

Lead Pastor(s) Phone Number (If Applicable)

Contact Person

Contact Person(s) Phone Number

Social Media URLs (Facebook, Twitter, etc)

Website

How long has your church/ministry been serving your community

Please list other national speakers that you have hosted in the past

Booking Request Information

Desired Date

Service Time(s) - Please include time zone

If this engagement request extends beyond one day, please list all dates.

Type of Engagement

If Other, Please Specify

Theme/Title (if conference, etc)

Other guest speaker(s) ministry date(s) & time(s)

Projected Attendance

Describe This Event

Closest Airport

Event Budget

Is there a registration fee for this event?

Are you receiving love offerings?

What is the amount you have budgeted for Kimberly Moses (excluding travel expenses)?

Product

Is the sale of ministry products permissable?

Contact Person

Contact Persons Phone Number and Email

Are you able to provide at least one (1) 8-foot table to display and sell ministry products?

Media Services

Please provide KMM with a complimentary video and/or audio of the service(s) if possible, along with any digital photos taken.

Will the service(s) be video recorded?

Audio Recorded?

Will the service(s) be live webcast?

If so, please list site.

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