Guest Speaker Worksheet – Alan Berndt | Developmental Testing Environment

Step 1 of 6 - Speaker/Ministry Information

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Guest Name*
First Last
Information about your ministry.
Ministry Name*
Ministry Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mailing address is same as street address?
- Yes
- No
Ministry Street Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Ministry Website
Ministry Email Address*
Ministry Phone Number*
Assistant or Contact Person Information
Name*
First Last
Email*
Phone*
We'd love to have a picture of you that we can use for any media.
Please attach a high-resolution image at 300 dpi or higher.

Date Ministering at The City Church*
MM
DD
YYYY
Time of Service*

: HH

MM
How early would you like to be at the service?*
Preferred Water On Stage*
- Bottled, chilled
- Bottled, room temp
- No Water
Speaking Specifics*
- 30" Flat Table
- 45" Flat Table (Standard)
- Podium
- Other
Please fill out "Other" here

Please upload a Signed W-9 Form as a PDF.*
Will your ministry be selling your products, or would you like The City Church to handle sales? (Please see details below)
- Our Ministry
- The City Church
The City Church will provide: -Tables and black tablecloths for merchandise display and sales (please send us the number of tables you need 2 weeks prior to the event). You will be responsible to provide: -Credit Card Machines (no phone line, only wifi machines please) -Banks for cash transactions -Merchandise & shipping to and from the event -Individuals to sell merchandise
The City Church will provide: -Tables and black tablecloths for merchandise display and sales -Individuals to sell merchandise -Credit card machines and banks for cash transactions *Please Note that 20% will be taken from final sales to cover an credit card transaction fees. You will be responsible to provide two weeks prior to the event: -Merchandise shipped to our offices no later than one week before the start of the event. The City Church, Attn. Retail Sales Manager, 9051 132nd Ave NE, Kirkland, WA 98033 -Return shipping labels for any remaining merchandise -An inventory list with products, ISBN numbers and price list -Any detailed directions for table setup
Name
First Last
Email
Phone

We book king, non-smoking rooms unless otherwise specified. Please list any hotel room preferences below. We will do our best to honor your preferences whenever hotel availabiliity allows.
Hotel Bed Preferences
- 1 King
- 2 Beds Required
- Adjoining Rooms
- Other
Please describe other:

Will you be making your own travel arrangements?*
- Yes
- No
Please provide date of birth and name exactly as it appears on the form of ID you'll be using to check into your flight.
Arriving by:*
- Commercial Flight
- Private Aircraft
- Car
If you are traveling by air and are making your own arrangements, we ask that you secure the tickets as early as possible to get the best rate. We recommend you fly into Seattle-Tacoma International Airport (SEA), which is 25 minutes from The City Church.

NOTE: Please submit travel itinerary one month prior to scheduled date to Carla Haskins at carla.haskins@thecity.org.
The City Church is planning on providing transportation for you and any travel companions.
Will you need someone to pick you up from the airport?*
- Yes
- No
Please give us the best phone number for a host to reach you.
Name
First Last
Relationship to you:
Name
First Last
Relationship to you:
Name
First Last
Relationship to you:
Name
First Last
Relationship to you:
The City Church intends to make audio and video recordings, take photos, and otherwise document your time at the church, including while you speak. By agreeing to speak at The City Church, you give the church the full right and permission to use your name, voice, photograph, and likeness and any recordings, photos, or other media in any manner and for any purpose deemed by the church to be appropriate for its ministry purposes.

The church will have full ownership rights in any videos, photos, or other media that use your name, voice, photograph, or likeness, including but not limited to (1) copyright them in the Church's name or in the name of any other person; and (2) publish and use them in whole or in part, in any manner and for any purpose deemed appropriate by the church for its ministry purposes.