9Marks: Survey - Workshop Request Form

Workshop Request Form

This form can be used to request a 9Marks Workshop.

To view Mark Dever's schedule, click here.

Contact Information

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

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

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 - Have you attended a 9Marks Weekender or a 9Marks Workshop?

Question - Not Required - Are you or is your church a member of a local association or network of pastors/churches (formal or informal)?

Question - Not Required - If so, describe this association or network and your involvement:

*5.

Question - Required - Have you reviewed the 9Marks Workshop Partnering Opportunities document?

To review the 9Marks Workshop Partnering Opportunities document click here.

Question - Not Required - What are your goals for this Workshop?

Event Information

*7.

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

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

*8.

Question - Required - What day would you like the Workshop to begin?

Month

Day

Year

*9.

Question - Required - What day would you like the Workshop to end?

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 do you expect to attend? Please provide a range, if appropriate (e.g. 25-50).

Event Location Information

14.

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

*15.

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

16.

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

17.

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