FREE School Assembly Request Form

 

1. There is no charge to Southern California schools.
2. Students may purchase a book and have it signed by the author.
3. The following information is needed for scheduling:

School Information

1. School Contact(required)
2. Address(required)
3. All Grade Levels at School(required)
4. Total Number of Students(required)

Your Information

1. Name(required)
2. Position(required)
3. Phone Number at School(required)
4. Email(valid email required)

Event Date

1. First Preferred Date(required)
2. Second Preferred Date(required)
3. Third Preferred Date(required)

Misc Information

1. Comments