9Marks: Survey - Speaker/Event Request Form

Speaker/Event Request Form

This form can be used to invite Mark Dever or other 9Marks speakers to your event.

To view Mark Dever's schedule, click here.

Please provide the following information for the primary point of contact for this invitation.

If you have previously registered, please login here to prepopulate your information.

Name:

First Required	Last Required

Email: Required

Street 1: Required

Street 2:

City/State/ZIP:

City Required	State Required	ZIP Required

Country: Required

Phone Number: Required

If you respond and have not already registered, you will receive periodic updates and communications from 9Marks.

Please enter a user name and password for logging in when you return. You can use this password to update your information or receive personalized content.

*	User Name: Required	5 to 60 characters
*	Password: Required	5 to 20 characters
*	Repeat Password: Required

*2.

Question - Required - How did you hear about 9Marks?

Speaker Information

*3.

Question - Required - Who would you like to come speak at your event?

Question - Not Required - If your above choice is not available for your event, is there an alternative speaker you would like to invite?

Question - Not Required - Do you have a second alternate speaker that you would like to invite?

If you would like to invite more than one speaker to your event, please complete all three speaker dropdown lists, and include a note in the comments field below with the specifics of your request.

Event Information

*6.

Question - Required - What organization will be the primary sponsor for this event?

(Maximum response 255 chars, approx. 5 rows of text)

*7.

Question - Required - What is the name of the event?

(Maximum response 255 chars, approx. 5 rows of text)

*8.

Question - Required - What is the first day the speaker will be speaking?

Month

Day

Year

*9.

Question - Required - What is the last day the speaker will be speaking?

Month

Day

Year

10.

Question - Not Required - Are these dates flexible?

11.

Question - Not Required - If the dates are flexible, please list in chronological order other potential dates.

(Maximum response 255 chars, approx. 5 rows of text)

*12.

Question - Required - Who is your target audience (e.g. pastors, elders, lay leaders, church members, general public, etc.)?

(Maximum response 255 chars, approx. 5 rows of text)

*13.

Question - Required - How many people in total do you expect to attend? Please provide a range, if appropriate (e.g. 75-100).

*14.

Question - Required - How many pastors, elders and/or seminarians do you expect to attend (e.g. 15-25)?

15.

Question - Not Required - If this event has been hosted previously, how many people in total attended the previous event?

*16.

Question - Required - How many talks would you like the speaker to give?

*17.

Question - Required - How long should the speaker plan to speak at each talk? (If multiple talks are varying lengths, please make a note in comments field below.)

*18.

Question - Required - What topic(s) would you like the speaker to address?

(Maximum response 255 chars, approx. 5 rows of text)

*19.

Question - Required - What should the speaker wear to this event (e.g. coat and tie, collared shirt and slacks, etc.)?

Event Location Information

20.

Question - Not Required - What airport would the speaker fly into, if applicable?

*21.

Question - Required - Where will this event take place? Please provide the city and the state/country (e.g. Louisville, KY or Berlin, Germany).

22.

Question - Not Required - What is the travel time from the airport to the event location?

*23.

Question - Required - What day do you expect the speaker to arrive at your event location?

Month

Day

Year

*24.

Question - Required - By what time should the speaker arrive?

*25.

Question - Required - What day do you expect the speaker could depart and return home from the event location?

Month

Day

Year

*26.

Question - Required - By what time do you expect the speaker will be able to depart from the event location?

Expenses

*27.

Question - Required - Will you be covering all of the travel expenses (i.e., airfare, lodging, meals, and rental car) for the speaker and his assistant?

28.

Question - Not Required - Would you consider allowing the speaker to bring CHBC/9Marks staff and/or interns, assuming they covered their own expenses?

9Marks Resources

29.

Question - Not Required - Will you provide 9Marks with a master-quality, digital audio and video recording (if applicable) of the speaker's talks to use at the discretion of 9Marks?

30.

Question - Not Required - If so, do we have permission to post the talk(s) on the 9Marks website?

*31.

Question - Required - Would you allow 9Marks to set up a display table to distribute free resources to your attendees?

32.

If 9Marks cannot have display table, we would still like to offer some free resources to your attendees. Please select the best way that these resources can be distributed.

(Select one of the available choices or enter a different value.)
Question - Not Required -

33.

9Marks would like the attendees to have the opportunity to purchase our books. How can we best accomplish this?

(Select one of the available choices or enter a different value.)
Question - Not Required -

Display Table Logistics

Who is the primary point of contact for the display table?

34.

Question - Not Required - First Name:

35.

Question - Not Required - Last Name:

36.

Question - Not Required - Phone Number:

37.

Question - Not Required - Email Address:

38.

Question - Not Required - Please provide any additional comments that you feel are necessary.

9 Marks : Building Healthy Churches

Speaker/Event Request Form

Speaker Information

Event Information

Event Location Information

Expenses

9Marks Resources

Display Table Logistics