Valerie J Lewis Coleman

Preliminary Booking Questionnaire for Valerie J. Lewis Coleman

Thank you for your recent booking inquiry for Valerie J. Lewis Coleman. Many details go into bringing Val to a city for an event. Please complete this form to expedite the booking process and assist us in meeting your request. This form serves as an invitation only and does not constitute confirmation of Val’s appearance. Return the completed form via e-mail to This e-mail address is being protected from spambots. You need JavaScript enabled to view it or fax it to 515.474.3643. Call 888.802.1802 with questions. Thank you.

Organization’s name:

 

Organization’s product, service or mission:

 

Organization’s address:

 

Organization’s website:

 

Contact’s name:

 

Contact’s work number:

 

Contact’s mobile number:

 

Contact’s fax number:

 

E-mail address (organization or contact):

 

Venue name:

 

Venue address:

 

Venue phone:

 

Type of presentation

(keynote, seminar, workshop, emcee):

 

Date(s) of presentation:

 

Time(s) of presentation:

 

Length of presentation:

 

Is the event ticketed or free to the public?

 

Expected number of attendees:

 

Audience description

(stepfamilies, women, youth, writers, etc.):

 

Other speakers confirmed for this event:

 

How will this event be publicized?

 

Will a table be provided to sell product?

 

Speaker budget:

 

Travel budget:

 

Name & address to mail

Appearance Agreement:

 

Valerie J. Lewis Coleman

893 South Main Street – PMB 175 | Englewood, Ohio 45322

ValerieJLColeman.com | 888.802.1802