Organization
Organization Name (*)
required
Senior Leadership (*)
* required
Website
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Address (*)
* required
Address Line 2
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City (*)
* required
Country (*)
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State/Province (*)
* required
Zip/Postcode (*)
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Phone (*)
* required
Fax
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Closest Airport
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How did you hear about KMM? (*)
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(ex. book, conference, other leader/ministry)
Prior to the event, we will ship product to the address given below.
This should be a physical address (not P.O. box) where UPS packages can be received.
Shipping Address
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Leave blank if same as above address

Contact Person

Contact Person Name (*)
* required
Title/Position
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(ex: "Personal Assistant")
E-Mail Address (*)
* required
Phone Number (*)
* required
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Phone Number 2
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Requested Dates

Below you may select up to 3 possible dates.
Requested Date
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Numbers of Days Requested
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If a weekend is not available, would you consider mid-week?
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Notes about requested dates:
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Event Details

Event Description (*)
* required
Number of Congregations Involved (*)
* required
(enter "1" if hosting alone)
Expected Number of Attendees (*)
* required
(please be as specific as possible)
What is the capacity of the event facility? (*)
* required
Other Speakers
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Ministry

Below, please give a brief description of your ministry
(*)
* required