Speaking Engagement

Covenant Life Ministries
959 Main Street, Suite 208
Stratford, CT 06615
(203) 386-9854 – Office (203) 386-9865 - Fax
Websites: www.clmct.org www.lovct.org
Office Email: covenantlife@cfaith.com

SPEAKING ENGAGEMENT FOR PASTOR CARMEN ACOSTA

Hosting Church/Ministry Information

Hosting Church/Ministry: *

Mailing Street Address: *

Address Line 2:

City: *

State: *

Zip Code: *

Physical address (If different from mailing address):

Address Line 2

City

State

Zip Code

Church/Ministry Phone Number (000 000 0000)

Contact Information

Who is the primary contact person? *

Primary Number (000 000 0000) *

Alternate Number (000 000 0000)

In case of emergency, please provide two contact names and numbers

1. Emergency Contact *

Contact (1) Number (000 000 0000) *

2. Emergency Contact *

Contact (2) Number (000 000 0000) *

Event Information

Type of Event *

Women's Conference

Church Conference

Other

Conference Location (if different from church):

Conference Theme: *

Pastor Acosta's required attier: *

Formal

Business Casual

Casual

Day 1 Date: * +

Day 1 Start Time: *

Day 1 End Time: *

Day 2 Date: +

Day 2 Start Time:

Day 2 End Time:

Day 3 Date: +

Day 3 Start Time:

Day 3 End Time:

Are there any special instructions or particulars to which Pastor Acosta should be made aware of?