Guest Speaker Request Form - Crossroads Church

Guest Speaker Info

Guest Speaker Name *

Mailing *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Ministry/Organization *

Administrative/Executive Assistant contact

Website / URL

Instagram/Facebook/Twitter/Youtube

Bio *

Key Ministry Accomplishments

Arrival Date *

Departure Date *

For tax purposes, which name should appear on the honorarium gift?

Travel Arrangements

Will there be anyone accompanying you? If so, please enter their name here

Will you be driving or flying? *

If flying, would you like us to book your flight or book your own and be reimbursed?

Please note, the closest airport is Columbus, Ohio CMH and is an hour away

Will you need a rental car? *

Would you like us to book a rental car or book your own and be reimbursed?

If you have already secured your travel arrangements, please enter information here. (Include arrival and departure date, time, and flight number)

Lodging Arrangements

How many hotel rooms will you need? *

Will you need any special accommodations for your hotel room? (ex. first floor access)

To whom should a reimbursement check be made payable?

Media

Sermon Title/topic? *

Do you plan on showing any video footage during your speaking engagement? (All Video submissions are subject to approval) *

Is it possible to send message notes and any media to Nicole.carr@crossroadswired.com by Wednesday of the week you are speaking? *

Other Media Needs

Resources

Will you be bringing resources or merchandise with you? *

Meal Preferences

Preferred Drinks/Snacks?

Do you prefer a meal before or after speaking?

What type of food would you like to eat while you are with us?

Do you have any allergies we should be aware of? *

Additional

Any additional questions or info

Guest Speaker Info

Travel Arrangements

Lodging Arrangements

Media

Resources

Meal Preferences

Additional

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