Higher Places Ministries

First Name

Last Name

Email

Event Name

Event Theme

Date of Event

Time of Event

Description of Event

Event Location

Address

City

State

Zip/Postal Code

Do you need a flyer for your event?

No

Yes

Please provide a description of what you would like your flyer to display:

Does your event need tables?

No

Yes

If yes, how many tables? Please be sure to email Tina, tcordero@higherplacesministries.org, in addition to this form.

Does your event need chairs?

No

Yes

If yes, how many chairs? Please be sure to email Tina, tcordero@higherplacesministries.org, in addition to this form.

Other:

Video

Media Request Form