Forgiven By Grace Ministries
PO Box 77090
Jacksonville, Florida, 32226-7090
(904) 766-6114 Office - (904) 766-5659 Fax

Brother Jay Ministry Information Profile/Agreement

Please provide the following information:

Date:__________________________

Ministry/Church Name/Event:__________________________________

Telephone:(____)_____________,Fax:(____)____________

Street Address:_____________________________________________

City:_______________, State:________, Zip:_____________________

Pastor’s Name:_______________________ Meeting Coordinator:____________________

Event/Meeting Date(s):_____________________

Expected Attendance for event:#______________

Type of Service/Event/Meeting:________________________

Location of Event if different from above:____________________________________________

Event Start Time:_____________Speaker Time:____________Closing Time:___________

Expenses: Travel Arrangements:

If driving to and from event all gasoline cost will be reimbursed: Deposit $_________Balance $_________

Full fare roundtrip air or train tickets will be provided: Yes:_______No:___________

Love offering $:_____________Honorarium $____________Tax ID# 593656507

Ministry Product Sales Table set up: Yes:____No:_____

Lodging:

Hotel accommodations will be provided for multiple day ministry events/meetings.
Hotel Name:__________________________________________________

Telephone #( ____)_________________

Please provide room temperature bottled water and apple juice in hotel room.
Hotel Address:__________________________________________________________________________

Name Room Listed Under:________________________________________________________________

Distance From Hotel to Event Location:______________________________________________________

Agreed and accepted by:
Signed _________________________________ Bro. Jay_________________________Date__________

Note: Please keep a copy and immediately fax return a copy to (904) 766-5659.
Then mail a copy of this form and confirmation to the address above.