Name *

First Name

Last Name

I Would Like to Book *

Xochitl-Julisa Bermejo

F. Douglas Brown

Muriel Leung

Kenji C. Liu

Soraya Membreno

Vickie Vértiz

For These Services *

Presentation/Lecture

Literary Reading

School/Classroom Visit

Workshop/Class

Panel

Other

Unsure at this time

Event Date

MM

DD

YYYY

Alternate Date

MM

DD

YYYY

*

I understand & agree it is my responsibility as host to cover the cost of speaker accommodations and travel.