Point of Contact *

First Name

Last Name

Phone *

(###)

###

####

What is the date of your event? *

MM

DD

YYYY

Time of Event *

Hour

Minute

Second

AM PM

Speaker Arrival Time

Is there a specific time you would like Min. Tee Jay to arrive?

Hour

Minute

Second

AM PM

Organization Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Venue Address

What's the address of the venue?

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Will there be a vendor table available for Min. Tee Jay to sell ministry merchandise? *

Yes

No