Name
*
First Name
Last Name
Organization / Church Name
*
Your Position In The Organization
*
Organization Phone Number
*
Country
(###)
###
####
Organization Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
*
Phone
*
(###)
###
####
Event Name
*
Event Date
*
MM
DD
YYYY
What Type Of Event Are You Hosting?
*
Event Description
*
Tell us more about this event. The vision behind it, purpose for gathering, etc
Venue Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Event Seating Capacity
*
Estimated Attendance Of Event
*
Other Speakers / Worship Leaders Confirmed For This Event
*
Number Of Sessions You Are Requesting LCW To Lead
*
Requested Date
*
MM
DD
YYYY
Date Option #2
MM
DD
YYYY
Date Option #3
MM
DD
YYYY
Closest Airport To The Event City
*
Which Leaders Are You Requesting?
*
Are You Requesting:
*
Have You Hosted A Life Center Worship Leader For A Previous Event?
Please write yes or no in the box below. If yes, please enter details of event such as worship leader, event name, event dates.
Additional Information
*
You Sound Engineer Name
You Sound Engineer Cell
Country
(###)
###
####
Disclaimer 1
*
Please read and check that you have read disclaimer
Disclaimer 2
*
Please read and check that you have read disclaimer
Disclaimer 3
*
Please read and check that you have read disclaimer
