Collaboration / Partnership Request

Point of Contact First Name *

Point of Contact Last Name *

Point of Contact Phone Number *

Point of Contact Email Address *

Company or Organization Name *

Company or Organization Website *

Location of Event or Collaboration (City & State or Virtual) *

Type of collaboration you are requesting (select all that apply) *

Description of the Collaboration You Are Proposing *

Estimated Date or Timeframe *

Expected Number of Participants / Attendees *

Event or Collaboration Theme (wellness, mental health, intentional living, detoxing, alignment, etc) *

Is This a Paid Collaboration? *

How did you hear about Tiffany? *

Additional Notes or Special Requests

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