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School Visit Request Form -- Out-of-State
Welcome educators! I am so excited to visit your school. Please fill out this form to get started.
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* Indicates required question
Your Name
*
Your answer
Your School
*
Your answer
Your School Address
*
Your answer
Your Email
*
Your answer
Alternate contact method
*
Your answer
What type of visit are you hoping to book?
*
One-day visit. Cost is $750 plus travel and lodging.
Multi-day visit. Cost is $650 per day plus travel and lodging. Limit 2 days.
Other:
What grade levels will Kim be speaking to?
*
3rd
4th
5th
6th
7th
8th
Other:
Required
Will you have a computer, projector and screen available for the presentation?
Yes
No
Clear selection
Where will presentations be held?
Library
Gym
Auditorium
Other:
Clear selection
What is your 1st preferred date?
MM
/
DD
/
YYYY
What is your 2nd preferred date?
MM
/
DD
/
YYYY
Thank you!
I will be in touch soon to finalize your visit :)
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