Request Form - New Life Refuge Ministries

SPEAKER REQUEST FORM
Thank you for requesting a speaker from New Life Refuge Ministries. We have a
strong base of speakers, and we are excited about educating your church or group
about human trafficking. Our presentations typically can be tailored to your time
frame required. Please fill out this form as thoroughly as possible and email it to
[email protected] You should hear back within three to five business days.
For more information about New Life Refuge Ministries, please visit our website
at www.newliferefugeministries.org.
Your Contact Information
Name:
Title or position:
E-mail:
Cell Phone:
How did you hear about New Life Refuge Ministries?
Event Information
Event Name:
Organization Hosting the Event:
Organization’s website:
Event Location/Address (Street, City, Zip Code):
Event Date:
Event Time:
Desired length of New Life Refuge Ministries presentation (minutes):
Do you have a desired New Life Refuge Ministries speaker that you would like to
present:
Brief Description of the Event:
Are you inviting other speakers to this event? If so, who?
What would you like New Life Refuge Ministries to cover in their presentation?
Estimated Attendance at Event:
Is this event open to the public?
Brief Description of the Audience (age, gender):
What is the depth of knowledge of the audience with regards to human trafficking? Is
this their first time to hear about human trafficking or are they pretty familiar with the
issue?
Are you charging a fee to participants to attend this event? If so, how much?
How will you advertise this event?
Will you have the following equipment available: (answer yes or no)
- Wireless Internet?
- Microphone?
o Wired mic?
o Wireless mic?
o Lavaliere?
- Laptop?
- Projector and screen for powerpoint?
- Speakers for sound for video?
- Will powerpoint be controlled by the speaker at the front of the room or a tech
person in the back?
Please describe (in a few sentences) how your organization plans to build on or follow
up this event. How are you planning to further engage human trafficking issues