Thank you for your interest in having Brian Doerksen participate in your event. In order for us to prayerfully consider this request, please submit as many details as you can. (required)

Dates Requested (specific or open)	or
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Contact Name (first and last)
Email Address
Phone Number
Cell Phone Number
Fax Number
Church or Event Name
Event Location
Event City
Event State/Province
Church or Event Website
Event Description (e.g. is it inter-denominational or one church?)
Brian's proposed role (leading worship, teaching, other?)
Who else will be leading worship or speaking?
Have your ever organized an event like this before? (briefly describe)
Number of expected participants?