Name *

First Name

Last Name

What kind of visit would you like to book? *

School visit

Library visit

Other

Proposed date of the visit *

MM

DD

YYYY

Alternative Date *

Please give another, back-up date that would work for you in the case of schedule conflict, day-of emergency, etc.

MM

DD

YYYY

How would you like to support Lyla for this visit? *

Book sales (a min. 30 book buy is required per visit)

Honorarium (see below)

Both (thank you!)

How many sessions are you interested in booking me for your visit? *

Please note: for school visits, I require a min of 2 sessions (a half-day) as they take a lot of time to prepare.

1 (for non-school visits only)

2

3 or more (please include # in message below)

Would you like me to incoporate a free creative writing activity with the students at the end of each session?

Please note that this will be at the last fifteen minutes of each session. For younger groups (first and second grade), the writing activity will be conducted as a group. Please provide an easel, board, or any other tools (i.e. markers) I can use to lead the activity. Older groups (third grade and up) will work independently and will need their own pencils, papers, and other writing supplies.

Yes

No