First Name Name Email Address Requested Author/Illustrator

Other

Date of Appearance (If flexible, please include several dates in order of preference) Type of Appearance (School, public library, conference or other) School / Library / Conference (Name and Address) Contact Person Name Contact Person Job Title Contact Person Address Contact Person Phone # Contact Person Email Grade Level of Audience Number of Presentations Book Signing Honorarium Offered (It is the responsibility of the organization to pay for all travel costs and expenses incurred by the author during the visit. These expenses are in addition to the honorarium) Additional Information (It is the responsibility of the organization to pay for all travel costs and expenses incurred by the author during the visit. These expenses are in addition to the honorarium)

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For inquiries please contact: Lisa.A.Mcclatchy@disney.com or childrens.marketing@disney.com