Speaker Request Form

Church or Ministry Name

Date Requested

Alternative Date




Zip Code


Phone Number

Church or Pastor Email Address

Senior Pastor/Leader

Website Address

Contact person responsible for booking this event

Email address of contact

Contact Phone

Please describe the type of meetings or conference and subject you are interested in scheduling Roland Martinez

Will you cover all expenses related to travel for the event (airfare, lodging, transportation, and meals)?

The CFL board prefers that Roland not travel alone. Would you cover the expense of a second person to travel?

Will there be other speakers at this event?

If yes, who

Estimated number of attendance

Is your church or ministry hosting this event alone or will there be other churches involved

Has Roland Martinez previously spoken at your ministry? Yes or No and if yes, when

Have you or anyone in your ministry led the marriage study, Two Becoming One?

Would you like to request Sally Meredith to speak?