Bulk Book Order Form

Dr. Brandi's Bulk Book Order Request Form
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www.leaderishmedia.com
Which Dr. Brandi book would you like to bulk order?*
Primary Contact Person Information
Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Role/Title*
Organization Name
Organization Website
Secondary Contact Person Information
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Role/Title
Organization Name
Organization Website
What type of copies are you requesting?*

Hardcopies $10/copyDigital Copies $5/copy
How many hardcopies are you requesting for Authentic Ally?*
Hardcopies @$10 each.
How many hardcopies are you requesting for Put in Work?*
Hardcopies @$10 each.
How many digital copies are you requesting?*
Digital Copies @$5 each
When do you need the copies by?*

MonthDayYear
Select a date approximately 5 business days prior to when you need the books.
Where should the hardcopies be mailed?
ATTN: Point Person*

First NameLast Name
Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you have the email list of individuals who will receive audio/digital copies? *

Attach a spreadsheet, word document or editable PDF where email addresses can be copied from.
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What will you use the books for?*

Conference GiveawayEmployee Gift/GiveawayMembership Association ResourceCorporate TrainingLeadership Development Event/ProgramPromotional ItemOther
What other questions do you have for our team?

Important Note Before You Submit
Submitting this form does not place a book order. Once we receive your request, our team will review it and send a confirmation email.
- Speaking engagements: If your event requires books, they will be invoiced separately as physical inventory and must be prepaid before being shipped.
Have questions? Reach us anytime at team@doctorbrandi.com.
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Dr. Brandi's Bulk Book Order Request Form