KFM Speaker Media Form

Please complete this form in its entirety.

Your Title

(If applicable)

Name

First Name

Last Name

Email Address

Phone

(###)

###

####

Church/Business Name

Title of Your Message/Workshop

Workshop Description (For Workshop Facilitators Only)

Please provide a brief (2-4 sentences) description of your Workshop that can be used for marketing purposes:

Scriptures

Please share any scriptures (include Bible version) that you would like displayed on the screen.

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