Dr. Ashley Booking Request
Thank you for your interest in Dr. Ashley Lowe-Simmons Workshop Services and Merch.  
We look forward to your event. Kindly provide the necessary information below. 
We will contact you within 24 hours to confirm your booking details and answer any questions you may have. 

Please note that this form does not guarantee an appointment, but only expresses your preference. We appreciate your cooperation and look forward to serving you soon.
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Email *
Do you understand that on top of Dr. Ashley's Professional fee, reasonable travel expenses will be charged to your organization.
These expenses may include round trip airfare, lodging, ground transportation, parking and/or meals.  *
Name and Title of Contact Person *
How did you hear about Dr. Ashley? *
Email *
Phone *
Name of Organization *
Organization Website *
Organization Status *
Required
Event Name *
Event Description *
Event Date *
MM
/
DD
/
YYYY
Event Time *
Time
:
Event Location *
Expected Number of Participants/Attendees *
Is the event free for the Participants/Attendees *
Required
If not free, how much is the admission price? *
Other Speakers Invited *
Event Sponsors *
Type of Presentation Requested *
Required
Speaking Duration (in Minutes) *
Budget for requested speaker / presentation *
Other special requests (check all that apply): *
Required
Is contact form or info sheet  to provided to the attendees? *
Will you allow my products to be sold or marketed at the event? *
Will any media outlets be present? *
Additional comments / info about Event: (Target audience/focus) *
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