Speaking Request
Are you requesting Dr. Asha or any of the 35+ Temple Fit Faculty to speak at your upcoming event? Please complete this request form. We use it to match you with the best fit speaker/facilitator for your program.

Based on the details of your request, Faculty may represent Dr. Asha; Temple Fit Co. Wellness Education & Events Agency; or Temple Fit Health, Inc. 501(c)(3). You will be contacted by the representing entity within 72 business hours of your request submission. Thank you for the opportunity to serve you!

Email: hello@templefit.co with questions.
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Email *
Organization Hosting Event
Primary Contact for Speakers
Include Name, Phone Number, and Email Address
Title & Themes of Event
Include any information that will help the speakers prepare, such as event topics, event colors, etc.
Date of Event
MM
/
DD
/
YYYY
Event Modality *
Physical Location of Event (if applicable)
Please include the street address, floor number (if applicable), and room number (if applicable)
Start Time of Event
Time
:
End Time of Event
Time
:
Event Audience Demographics
Share information that will help the speakers cater the presentation, such as the following: gender, ages, occupations, education levels, race/ethnicity, etc.
Number of Anticipated Attendance
Type of Presentation Requested
Topic Requested (from Dr. Asha)
Current topics offered by Dr. Asha. Descriptions at http://www.doctorasha.com/speaking/ 
Topic Requested (from Temple Fit Co. partners)
Current topics offered by Temple Fit Co's wellness partners
Start Time of Workshop/Presentation/Address
Time
:
End Time of Workshop/Presentation/Address
Time
:
Your Budget for Speakers *
Comments
Agreements
Please note that we will need your assistance with the following:
1. Wireless lapel microphones for all speakers
2. One table per speaker to make helpful merchandise available to your audience
3. One guest event ticket (and meal ticket, if applicable) for each speaker's assistant
4. Advance copy of the agenda/outline of events sent via email to hello@templefit.co 
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