Booking Enquiry Form

Booking Enquiry Form

Thank you for your inquiry. To better serve you we will need your completed form. Once we receive the filled form, we will contact you within 48-72 business hours.
Company/Organization's Name *
Company/Organization's Website *
if none available place n/a
Contact's Full Name *

First Name Last Name
Contact's E-mail *
example@example.com
Contact's Phone Number *
Event's Location (City, State & Venue); If Virtual please indicate the space *
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
What is the purpose of your event? (Example: Teen Program, Parenting Group, Church) *
Which workshop are you requesting? *
What is your proposed date for your event? If there is secondary date please list that as well. *
Number expected in attendance *
If tweens or teens will be in attendance what are the grade levels? *
How much time does Tanya have to speak for this event? *
Type a question
What is your budget for your requested speaker(s)? *
Is there any additional information you believe Tanya needs to know to be prepared for this event? *
Should be Empty: