Booking Inquiry Form

Bring Aytia to Your Organization

Interested in booking Aytia Tarpley for a keynote, professional training, panel, consultation, or event? Tell us a little about your organization and what you're planning. We'll review your request and follow up regarding availability and next steps.

Contact Information

Full Name

Phone

Title/Position

Please enter ‘N/A’ if not applicable.

Company/Organization

Please enter ‘N/A’ if not applicable.

Organization Website

Please enter ‘N/A’ if not applicable.

Tell Me About the Engagement

Event/Program Name & Date

In Person / Virtual / Hybrid

Is your date flexible?

Estimated Audience Size?

Who will be in the audience? What would you like your audience to learn?

For example: child-welfare professionals, law enforcement, attorneys, healthcare professionals, educators, parents, students, community members, etc.

What is your anticipated speaker/training budget?

Customized trainings, extended programs, consulting, travel and multi-session engagements are quoted separately.

Limited community/nonprofit rates may be available.

What service are you interested in?

Which topic(s) are you interested in?

Logistics

Will travel be required?

More than a 150 mile radius from Charlotte,NC.

If yes, does your organization cover approved travel and lodging expenses separately from the professional fee?

Will the presentation be recorded or livestreamed?

Final Questions

How did you hear about Aytia?

Submitting this form does not confirm a booking or reserve an event date. Engagements are confirmed only after ATC approves the request, both parties execute the applicable agreement, and any required deposit is received.

Booking Inquiry Form

Contact Information

Tell Me About the Engagement

Logistics

Final Questions

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