ELENI TASSOPOULOS WEHNER APPEARANCE REQUEST FORM
Preferred Date and Time For Eleni's Visit
/
Month
/
Day
Year
Date
Time
Hour Minutes
AM
PM
AM/PM Option
Alternative Date and Time For Eleni's Visit
/
Month
/
Day
Year
Date
Time
Hour Minutes
AM
PM
AM/PM Option
Name of Institution
School or Business Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Host or Contact Name
First and Last
Host or Contact Email address
Host or Contact Phone number
Please describe who will be in the audience (including ages and/or grade level), number of peope in audience, and expected presentation length. Include any other questions/requests you have.
Will you be ordering books for this visit?
Please Select
Yes
No
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