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First Name*

Last Name*

Position / Title

Email*

Phone

Business / Organization / Church / Ministry Name*

Name of Event

Type of Event*

Event Website (if applicable)

Event Date*

Month

Day

Year

Alternate Date

Start Time

End Time

Will this event be:*

In Person

Virtual

Hybrid

In Person Event Location

Expected Number of Attendees*

Under 50

50-100

100-250

250-500

500-1,000

1,000-5,000

5,000+

Who is the primary audience?*

Women

Young Adults

Teens

Ministry Leaders

Recovery Community

Pregnancy Center Clients

General Church

Book Readers

Mixed Audience

Other

What would you like Nina Grace to do?*

Keynote Message

Bible Teaching

Testimony

Prayer/Intercession

Panel Discussion

Interview (Podcast/TV/Radio/Magazine)

Q&A

Workshop

Breakout Session

Meet the Author/Author Reading/Book Signing

Host an Event

Other

Are there specific topics you would like covered?

Share more about your event and what you're hoping to accomplish.

Will the event be recorded?*

Yes

No

Unsure

Other

Will travel be required outside USA?*

Yes

No

Is there anything else you'd like Nina Grace to know?

I understand this is a booking request and not a confirmed booking.

I understand that submitting this form does not guarantee availability.

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