Author | Speaker | Educator | Producer
Organization Name
Organization Address
Event Address
Organization Type (Select at least one + Select all that apply)
Schools + Educational Programs
National Civic + Local Community Based Organizations
Other Speaking + Engagement Opportunities
Book Reading - 1 Classroom
Book Reading – Up to 25 Students
Keynote/Panel Speaking
Book reading - 2+ Classrooms
Book Reading – 26 – 50 Students
Fair/Festival
Book reading - 3+ Classrooms
Book reading – 51+ Students
Conference
Book Reading - Assembly
Teach Class/ Workshop – Up to 25 Students
Book Store Visit
Teach Class/Workshop - 1 Classroom
Teach a Class/ Workshop – 26 – 50 Students
Other
Teach a Class/Workshop - 2+ Classrooms
Teach a Class/ Workshop – 51+ Students
Teach a Class/Workshop - 3+ Classrooms
Fellowship/Residency
Curriculum or Program Design
Fundraiser
Is this organization a 501(c)(3) or other nonprofit organization?
YesNo
Author Visit - School ClassroomAuthor Visit - School AssemblyAuthor Visit - Book StoreBook or Art Fair/FestivalClass or WorkshopConferenceFellowship or Artist ResidencyFundraiserKeynote AddressPanelistOther / Please specify
Preferred Dates #1 (All times are in Eastern Time Zone)
Preferred Dates #2 (All times are in Eastern Time Zone)
Preferred Dates #3 (All times are in Eastern Time Zone)
Preferred Format
OnsiteVirtual
Organization Point of Contact
Name
Email
Phone
Does your organization have a budget for this event?
YesNoUnsure
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