Host Your Non-author Public Event with Book Around Organization/Host Name * Contact Person Name * First Name Last Name Email * Phone * (###) ### #### Website http:// Event Title * Type of Event * (workshop, class, meeting, Book launch Reading Signing Discussion Other Preferred Event Date * Please select preferred event dates in order of preference MM DD YYYY Preferred Event Date * Please select preferred event dates in order of preference MM DD YYYY Preferred Event Date * Please select preferred event dates in order of preference MM DD YYYY Preferred Event Date * Please select preferred event dates in order of preference MM DD YYYY Preferred Event Start Time * Please select preferred event times in order of preference Hour Minute Second AM PM Preferred Event Start Time * Please select preferred event times in order of preference Hour Minute Second AM PM Preferred Event Start Time * Please select preferred event times in order of preference Hour Minute Second AM PM Preferred Event Start Time * Please select preferred event times in order of preference Hour Minute Second AM PM Estimated Event Duration * Expected # of Attendees * What is the main purpose of this event? * (educational, networking, community outreach, etc.) Who is the target audience? * (local community members, professionals, families, etc.) How do you plan to promote this event? * Would you be willing to make a voluntary contribution to help cover additional marketing support to increase the event's exposure? * Yes No If yes, please indicate the amount you are considering. (this is optional) Any specific needs for the event? * Do you have any additional requests or specific instructions for the event? Anything else we should know? How did you hear about us? First Name Last Name Thank you!
