The Lilly Walls Firm Service Request
This Form Serve as our Preliminary Consultation to discuss Goal, Objectives and to verify that we are a true Service Match. This Appointment is for this purpose, proceeding scheduling will then follow.
Your Full Name
*
First Name
Last Name
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is this Consultation for?
*
Please Select
My Personal Artistry
My Independent Business
An Agency/Company
A Community Event
More than one option Applies
Tell us what kind of work we will be doing
If More Than One Applies: (Please Select All That Apply)
Type My Personal Artistry 1
My Independent Business
An Agency/Company
A Community Event
Which Services are you looking to subscribe to? (Please Choose All That Apply)
*
Strategic Consulting
Electronic Press Kit Creation
Website Development - Not Maintenance
Event Planning
Event Production
Script Writing
Stage Management
Other
If a Business, What is the Name being Consulted
*
I need to know who I will be working with
What is the Personal Desired Outcome & Goals you seek to accomplish from Consulting?
If this is an Event, What are the expected roles to be facilitated by The Lilly Walls Firm
What date and time work best for you?
Any other specific date and time, if the above selection is not suitable.
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Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Our Services Require a monthly Retainer of $150 (the consulting rate, with an ensured 5 hours for the month).
It is the patron's responsibility to schedule their time throughout the month. No extensions beyond expiration date without new months retainer if you do not utilize your 5 hours with in the allocated time.
Would you like to be notified about promotional services?
Yes
No
Submit
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