Request an Event Speaker

Event Name:* 
Name of Group or Organization: 
Date(s) Requested:* 
Event Location:*
Event Contact Person, Title:* 
Phone Number:* 
E-mail:* 
Address (if different than event location):
Typical attendee of event (e.g. youth, pastors, Lutheran or interfaith, church body, interests, etc):
Event theme or suggested topics for speaker:
Needs for speaker & time required (e.g. keynote, Bible study, lead a workshop, host a booth, etc):
General schedule or length of time for event:
Total expected attendance: 
Why did you choose LWR to be a part of your event?:
Are you able to share attendees’ contact information so LWR can stay in touch about our important ministry?: Yes
 No
Will there be an event packet or welcome bag that could include LWR materials?: Yes
 No
Are you able to cover travel costs for an LWR speaker to attend your event?: Yes
 No
 Partially
Which best describes the level of familiarity that attendees of the event will have with LWR?: Very little – interested in an introduction to the life-changing work of LWR
 Some – interested in finding new ways to engage with LWR or learning more about our work
 Great – but still interested in learning more!
 Mixed
Do you have a preferred speaker? 
LWR cannot guarantee the availability of a particular speaker, but will do our best to accommodate your needs and wishes.

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