Ministry Request Form

Crown Him Home Ministry Policies

   Please view our Ministry Policies before filling out this form. Your form cannot be accepted    unless you do so and acknowledge it on the form.

                                         *** All items with an asterick (*) is required. ***

  * Church/Ministry Name:

  * Physical Location Address:

  * City:                                                             * State or Providence:  

  * Zip Code or Postal Code:       Country:   

   Mailing Address (if different from above):

   City:                                                              State or Providence:  

   Zip Code or Postal Code:       Country:   

  * Phone Number (including area code):   

   Fax Number (including area code):         

  * Contact Person:   

  * Email Address:    

   Denomination or Ministry Affiliation (if any):

   Number of Congregations involved in the Meeting(s):   

   Number of People Expected to Attend the Meeting(s):   

  * Your Vision or Theme for the Meeting(s):

  * It is requested that a plan of serious intercession be made and kept for the
   meetings and the protection of the ministries who will be serving you.
   Please describe your intercessory plan for the meetings:


   Your Requested Dates and Times:

   Month:  Days:  Year: 
   Month:  Days:  Year: 
   Month:  Days:  Year: 
   Month:  Days:  Year: 

   Planned Speaking/Ministry Schedule:

   Date:  Time(am/pm): 
   Date:  Time(am/pm): 
   Date:  Time(am/pm): 

   Other Confirmed Speakers/Ministries for the Meetings:

  * Ministry Table for Product(s) Contact Person:

  * I have read and understand the Ministry Policies (check here):   


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