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Booking Request Form
Thank you for your interest in having Pastor Billy Burke minister in your church or at your special conference! Pastor Billy is currently planning his 2012 itinerary and would like to begin dialogue in regards to your desire to facilitate the ministry. If you would kindly provide the following information, it will move the process along so we can determine the possibility and dates to be scheduled in a timely manner.
Contact Information
Name (*)
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Title/Position (*)
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Phone Number (*)
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Email (*)
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Fax
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Location Information
Church/Venue Name (*)
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Pastor/Host Name (*)
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Address (*)
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City (*)
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State/Province (*)
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Zip Code (*)
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Country (*)
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Phone Number (*)
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Venue Email
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Website
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Event Information:
Requested Date(s) (*)
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Alternate Date(s) (*)
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Service Times (*)
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Number of Expected Guests (*)
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Additional Details
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How did you hear about us? (*)
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All requests are reviewed by Pastor Billy and his Crusade Coordinator. Your form will be processed in a timely manner and a ministry staff member will contact you for further details. All submitted information will be kept private and confidential. For further information or additional questions, please contact our office at 1-888-7-HEALED. We look forward to receiving your request!
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