Please note that I am away from email and tech on Saturdays + Sundays

Request Form

Name

First Name

Last Name

Phone Number

(###)

###

####

Group, Organization, Business

Please name who is requesting services, collaborative invitations or support.

Type of Request

Teaching - Virtual

Teaching - In person, On site

Speaker or panel invitation - Virtual

Speaker or panel invitation - In person, On site

Creative Projects - Writer, Performance, Photo, Video, etc.

Outdoor Guide - Day Hike

Backcountry Guide - Overnight

Interview - Podcasts, Print, etc.

Other (please fill out the next line)

If you chose Other from above, please describe your request.

Number of People Expected at Your Event

Name & Description of the Event

If in person, please include location.

Hour(s) & Date(s) for Your Event

Goals & Intentions for Your Event

What topics are you interested in me contributing?

What is your budget for this request?

How did you hear about my work?

Please list any relations or avenues that brought you to my website & services.

Is there any other information that you want to share about your event or the request?

Contact Form

*Please use this form for general questions about my cultural work & art practice.

Name

First Name

Last Name

Subject

Message