Dr. Pearce thanks you for the honor of inviting him to serve your organization. Please complete this form to request Dr. Pearce as your guest speaker.

We ask that you allow a minimum of 1 week for consideration of your request. In the interim, should you need additional information, please feel free to connect with us: booking@nicholaspearce.org.


* Required

Name of Organization*


Host Name*
(i.e. Host Pastor, Conference Host, Principal/University President/Dean, CEO/Unit Head)


Contact Person*


Address (Line 1)*


Address (Line 2)


City / State/ ZIP Code / Country*


Contact's Phone Number*  Alternate Phone Number
 


Email Address*   Website
 


How did you hear about Dr. Nicholas Pearce?*


Date(s) & Time(s) Requested*  Event Location*
 


Event Theme*
(Conference Theme, Worship Service Theme/Scripture)


This event is primarily for. . .*
(select one)

Ministry
           Youth/Teens
           Young Adults
           Youth & Adults
           Pastors & Leaders


Educational Institutions
           Elementary School Students (grades K-5)
           Middle School Students (grades 6-8)
           High School Students (grades 9-12)
           College (Undergraduate) Students
           Graduate Students
           Faculty/Staff


Corporations & Organizations
           Interns
           New Hires
           Minority Employees
           Managers/Team Leaders
           Executives


Other
          

What is the expected attendance for this event?*


Will air transportation be provided?*
           Yes
           No
           Not Applicable
           Not Sure


Will ground transportation be provided?*
           Yes
           No
           Not Applicable
           Not Sure


Will lodging accommodations be provided?*
           Yes
           No
           Not Applicable
           Not Sure


Hotel Name & Location


Will copies of the audio or videotaped session(s) be provided at the completion of the event?*
           Yes
           No
           Not Applicable
           Not Sure


Additional Information