ENGAGEMENT REQUEST FORM Contact Us Please designate which Pastors you are requesting: * Dr. Charles E. Perry Lady Charlette E. Perry Both Pastor and Lady Perry Pastor's Name * First Last Name * Last Text Church / Ministry Name: * Address * Street Address * Address Line 2 * State/ Province/ Region City * Country/Region: Email Website Confirm Email Contact Name * Contact Name First First Last Last Contact Phone Alternate Phone Type/ Theme of Event Location of Event Is your event date flexible? * Yes No Possibly Message * reCAPTCHA If you are human, leave this field blank. Submit
