JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Submit the form below to request an in-person or virtual author visit for your school, library, camp, daycare, or youth organization!
Event Timing: February 25, 2023 - June 30, 2024
For any questions, contact
authormdomino@yahoo.com
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Author Visits Available. Limited Dates.
*
Your answer
Representative's name
Your answer
Name of School/Institution/Organization
*
Your answer
City, State
*
Your answer
Date
*
Friday, May 10 (open times)
Friday, May 17 (open times)
Friday, June 7
Friday, June 14
Friday, June 21
Friday, July 12
Friday, July 19
Friday, July 26
Other:
Time
*
Your answer
Type of visit
*
Virtual (Free Visit)
In-person (Travel and/or lodging fee if outside of Baton Rouge, LA. Varies dependent upon location).
Other:
Number of Participants
*
Your answer
Grade Level (if applicable)
Your answer
*With this visit, I agree to support the author by distributing order forms to teachers, librarians, students, and parents prior to the visit. Order forms will be sent in advance along with other fun activity sheets and/or coloring pages.
*
I have read and agree with the terms and conditions.
Required
Comments/Questions
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms