Author Visit
Scheduling Form

To get you in the system and officially set up a visit, we’ll need some more information. Please fill out this form and we’ll be in touch with next steps.

Name

First Name

Last Name

Title

Phone

(###)

###

####

School or Organization

Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

School/organization phone and extension

(###)

###

####

Organization type

Approximate date you'd like to schedule the visit

Approximate number of students who will participate

Grade levels of students who will participate

Room

Please describe the room you'll be using for the presentation

Probable funding source

How did you hear about me?

Additional notes, questions, or comments

Author Visit Scheduling Form

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Author Visit
Scheduling Form