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Name of Organization:
Physical Mailing Address (not P.O. Box):
Name of Pastor or President:
Size of Membership:
Date of Event:
Event Location (If different from organization) :
Primary Contact for Event:
How many times does this event take place?
Type of Event:
Number of Presentations requested:
Will MMH be the keynote speaker or one of many?
One of Many
Please list other speakers:
Are the attendees interested in purchasing books?
Offered honorarium (amount)