Speaker Request Form

This form allows you to request a speaker. Upon receipt, your information will be recorded, reviewed, and a Public Relations staff member will contact you regarding the status of your request. In the interim, if you have an inquiry, please e-mail: publicrelations@tdjakes.org

Speaker Information

Name of requested speaker:
Why are you requesting this speaker?:
Are you willing to accept another
speaker from this organization?:

Presentation Information

What is the topic?:
What is the presentation format?:
What equipment will be available?:

Event Information

Date:
Begin Time:
End Time:
Location:
Event Title/Name:
Purpose of event:
Theme:
Will there be pre- or post-activities?:
If yes, explain?:
NOTE: If you are requesting Bishop T. D. Jakes as your speaker, please observe the following. All speaking requests for Bishop Jakes must be in letter form, in writing, on official letterhead, and signed by the senior pastor or a key executive. Mail your request to: The Potter's House of Dallas, 6777 West Kiest Boulevard, Dallas, Texas 75236, ATTN: Executive Office.