School Request FORM

Book a Presentation or Speaking Engagement

Submit a request to bring Simmons 3 to your school, organization, or event. All requests are reviewed based on availability, scheduling, and program fit, and we’ll follow up with next steps. Please allow additional time for out-of-state requests.

First name

Last name

Email address

Phone number

Organization / School Name

Event Address

City

State

Date Flexibility

Specific date required

Preferred date, but flexible

Flexible within a timeframe

Open to any available date

Preferred Date (if applicable)

Month

Day

Year

Additional Details (Bell schedule, timing constraints, or anything we should know)

Estimated Audience Size

Is your school or organization able to provide financial support for this program?

Yes

No

Unsure / Need more information

You are encouraged to submit a request regardless of your current funding status.

How did you hear about us?

If social media or other, please specify (optional)