Broken Clay Ministries

Unveiling the Kingdom

Ministry Engagement Request Form

Larry L. Graham, Evangelist and Teacher

Thank you for your interest in scheduling Larry L. Graham for your upcoming event. Please complete the following form so we may prayerfully consider your request.

Contact Information

Church / Organization Name: (Required)

Senior Pastor / Leader Name(Required)

Contact Person (if different): (Required)

Phone Number: (Required)

Email(Required)

Mailing Address: (Required)

Event Details

Type of Event (check all that apply):(Required)

Sunday Service

Revival / Crusade

Conference

Seminar / Workshop

Other

Proposed Event Title/Theme: (Required)

Event Dates: From (Required)

Event Dates: To(Required)

Preferred Service Times: (Required)

Expected Attendance:(Required)

Location

Venue Name: (Required)

Venue Address: (Required)

Accommodations & Arrangements

Will you provide:

Hotel accommodations

Transportation

Honorarium / Love Offering

Additional Notes or Special Requests:

Authorization

I, the undersigned, acknowledge that I am authorized to submit this request on behalf of my church/organization.

Name:(Required)

Signature(Required)

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Date(Required)

Month

Day

Year

brokenclayministries1@gmail.com

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