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BOOKING

Thank you for your interest in booking Apostle Jeremiah Fountain to speak at your event. Please complete the following form and we will get back to you as quickly as possible.

Ministry / Organization Name*

Ministry /Organization Email*

Ministry / Organization Website

Primary Contact Information

First Name*

Last Name*

Primary Contact Email*

Primary Contract Phone

Event Information

Events Type *

Ministry Needs*

Prophetic Worshiper

Prophetic Speaker

Keynote Speaker

Conference Speaker

Event Name & Theme*

Event Address*

Street Address Line 2

City*

State*

Zip*

Event Start Date*

Event Start Time

Time

:HoursMinutes

Event End Date*

Event End Time

Time

:HoursMinutes

Do you believe in the following: (please select all the apply)*

Speaking in tongues

Laying on of hands

Deliverance, with possible manifestation

Anointing others with oil

Write a message

Suggested Topic for Apostle Jeremiah*

Apostle Jeremiah's Speaking Date & Time

Speaking Date*

Event End Time

Time

:HoursMinutes

Duration of Speaking Time*

Targeted Demographics of Audience (please check all that apply)*

Married

Unmarried

Men

Women

Youth

Will there be display table(s) available to sell merchandise? If so, what size and do you have someone to work the table(s)?*

Travel & Hotel

Will there be a driver provided to and from event?

Audio / Visual

Will the service(s) be video-recorded?*

Yes

No

Will the service(s) be audio-recorded?*

Yes

No

Can you provide links to the event if being live-streamed?*

Yes

No

N/A

Can you provide copies of audio/video master tapes following the services?*

Yes

No

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