BOOK MYLES + DELANA If you have additional questions, please email nicolel@worshipwithwonders.org Rutherford Ministry Request Thank you for requesting Pastors Myles & DeLana Rutherford to attend your service. Please complete the following information as soon as possible to secure your ministry date. Your Name* First NameLast Name E-mail* example@example.com Phone* -Area CodePhone Number Church/Organization Name* Pastor's Name (if different from person completing the form) First NameLast Name Please enter the website of your church or organization.* Event Information Please provide as much detail as possible about your service/event. Requested Speaker* Pastor Myles RutherfordPastor DeLana Rutherford Name/Type of Service/Event* Service/Event Date & Time* -Month -DayYearDate Picker Icon Hour Minutes AM PM AM/PM Option Allotted Time for Ministry* Please include the total amount of time allotted including message, altar call, etc. Please list any additional flexible dates for consideration. Venue Address* Street Address Street Address Line 2 CityState / Province Postal / Zip Code Please Select Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Republic of the Congo Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia South Sudan Spain Sri Lanka Sudan Suriname Svalbard eSwatini Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands Isle of Man US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Expected Attendance Less than 100100-300300-500500-10001000+ Event Attire Please Select Casual Semi-Formal Formal Doesn't Really Matter Will there be any additional special guests in attendance?* YesNo If yes, please list any special guests that will be in attendance. Honorarium* Please indicate the amount of honorarium planned. Travel Reimbursement* Travel reimbursement is in addition to honorarium and includes mileage over 50 miles from home church or flights for 2 people, and hotel accommodations. Check the box to acknowledge this agreement. Hotel Information* Please provide the name and address of your host hotel. Is the sale of the speaker's products or merchandise permitted?* YesNo How did you hear about our ministry?* Is there any additional information you would like us to know about your service/event? Submit Should be Empty: