Multimedia Request Form

All requests must be submitted 3 weeks prior to the event date. Requests submitted within 1 week of the event date will incur a $50.00 fee.

Today's Date

First & Last Name

Phone Number

Email Address

Preferred Method of Communication

Phone

Text

Email

Is this a church—sponsored event?

Yes

No

Ministry Name

Ministry President Name

Name of Your Event

Date & Time of Your Event

Month

Day

Year

Time

HoursMinutes

Location of Your Event

Event Address

Graphics Requested

Flyer/Poster

Full/Partial Screen Text

Lower Thirds (Names, Titles, etc.)

N/A

Is the event organizer a current member of Antioch Missionary Baptist Church

Yes

No

If a non-member, I acknowledge I will be charged $150.00 for Antioch Missionary Baptist Church Multimedia Ministry services.

I acknowledge requests submitted within 1 week of event date will incur a $50.00 fee.

MULTIMEDIA REQUESTS