FJA PROGRAM REQUEST FORM

Select 2 possible dates on which you would like us to visit your church. These dates will need to be approved by our general committee in hopes of being able to ensure that our staff is available that day and that it does not conflict with a prior commitment.

Name

First Name

Last Name

Phone

(###)

###

####

What is the theme, or topic?

Pick One

Who is the audience? (Ages)

What time does morning service start?

What time does afternoon service start?

Will you have someone give the Sabbath School lesson?

Will staffing for service platform be needed?

(Prayer, Lecture, Offering)

Will you need a speaker for sermon?

What language would you like the program to be in?

Describe your church.

(Traditional, Contemporary)

Praise Team?

Food Arrangements:

Approx. how many members?

Requested Date 1:

YYYY

Requested Date 2:

YYYY