Virtual Author Request Form- Brock Greenhalgh
Thank you for your interest in a virtual author visit with “Hard Road to Victory: The Chatham All-Stars Story” author Brock Greenhalgh. Please answer the following questions, and we will get back to you shortly! This does NOT obligate you to booking a virtual visit. Another more detailed form will be sent soon. Thanks again!
Sign in to Google to save your progress. Learn more
Email *
Your name and title *
Your email address (Your email address will not be added to a mailing list or shared with anyone) *
Your school name and mailing address *
Do you have any specific dates in mind? *
MM
/
DD
/
YYYY
Do you have any specific time in mind? (Visits typically last 45 minutes) *
Time
:
Are you interested in selling the book "Hard Road to Victory" to your students? (Peppett Publishing offers a discounted price for students. Each copy costs $15. Five dollars from every sale is donated directly to the Black Mecca Museum in Chatham, Ontario. Copies will be personalized by Brock and mailed to the school at no extra cost) *
Do you have any other questions at this time? List your questions here and Brock will respond via email.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms