Name of Church/Organization
Physical Address
Mailing Address
City, State, Zip
Phone Number
Name of Contact Person
Preferred Speaking Date
Select Which You Prefer
Times of the Meeting or Workshop ?
Workshop requirement of 14 hours over a weekend is typically three hours on Friday, eight hours on Saturday and three hours on Sunday afternoon.
Start Time & Length of Speaking in Main Meeting
Purpose for Request ?
Church Service/Special Meeting only and or which workshop you are requesting.
Special Topic
Audience Size/Age ?
Please include average attendance for regular services and projected attendance for the workshop. This will help SOM representatives bring the appropriate amount of materials to serve your organization.
Will this Event be Promoted?
Video Projector Available for Speaker's Use?
What is the Appropriate Attire for the Speaker?

Thank you for your time. If you have any questions, please contact SOM Staff.