Speaking & Media Requests
Thank you for your interest in booking Atlanta Redemption Ink.  Please fill out the section below to the best of your ability. If you do not have all the details yet, that is ok.  
We can not grant each request but each will be reviewed and we will respond in a timely manner.

Thank you

Sign in to Google to save your progress. Learn more
Name  (include org, business, agency name if it applies) *
Phone Number *
email *
website *
name of organization/company *
type of request *
Event Location *
Name of Event/Program/Show *
Date Requested for Event *
Requested Speaking time *
Event Start and End Time *
Event Description *
Estimated Audience Size *
Will we be speaking during multiple sessions/events *
Please share a little about the event/show audience demographics *
Length of speaking time *
Requested Topic (Jessica's Story, Atlanta Redemption Ink, Awareness and Tattoo Identification, etc) *
How Did you hear about Atlanta Redemption Ink/Jessica? *
Can You Provide the Following *
Can this accommodation be for two?
Clear selection
Do you have a set honorarium? This is requested out of honoring survivor speakers (including Jessica) *
Will your organization or company be willing to? *
Additional Information You'd like to share. *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy