Name
*
First Name
Last Name
Your Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Organization / School / Event Name
*
Your Role / Title
Type of Event
School Assembly
Conference or Association
Corporate or Business Event
Library or Community Event
Other
Audience Age Range
Elementary
Middle School
High School
Adults
Mixed Ages
Event Location
Preferred Date or Timeframe
Would you be interested in offering a signed copy of one of my books to each person in attendance?
Yes. Send me information
Maybe. Sent me information
Not at this time
What are you hoping this event creates for your audience?
Anything else I should know?
Preferred way to connect
Email
Phone
Either is fine
Submit
Should be Empty: