school assembly speaker
assembly
School Educational Speaker Richard Paul THE BULLY PREVENTER™

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Request for a Booking

In order to provide you with a proposal and help make your event a success, we ask that you answer the questionnaire below.  If you prefer to speak to us directly, please call us at 800-579-8051 or email richard@richardpaul.com or fax it to 586-416-1159.

Event Booking Questionnaire

Ha Ha Halloween

HO HO Holiday

Clean Corporate Comedy

Cub Scouts

Family Fun Night

 


*Date(s) of Event: (mm-dd-yyyy)

*Type of Event:

Time(s):

*Location:

 
Name of Location
Address
City, State, Zip
Performance Location
(gym, cafeteria, auditorium)
Phone
Fax
 
*Services Needed - please
pick one type and one event:
Type of Service
(please pick one)
Event
(please pick one)
Elementary Assembly

I Feel Good
It's OK to Walk Away
No Bully Club
Diversity is Cool
Core Democratic Values
Hey Dude, Don't be Rude
NOT SURE - NEED TO CONSULT

Middle School Assembly Being a Wise Quack
Putting Your Web Foot Forward
No Bully Club
NOT SURE - NEED TO CONSULT
   
High School Assembly Being a Wise Quack
Putting Your Web Foot Forward
NOT SURE - NEED TO CONSULT
       
Youth Conference Being a Wise Quack
Putting Your Web Foot Forward
No Bully Club
NOT SURE - NEED TO CONSULT
       

Parent/Teacher Keynote Speaker

Being Ducky Keynote or Training
Stop the Bullying Keynote or Training
Stop the Teasing
NOT SURE - NEED TO CONSULT
   

Other keynote speakers you have had:
 

Ventriloquist Shows Available Fantastically Funny Family Entertainment Show
Clean Creative Corporate Comedy Show
Ho Ho Holiday Show
Ha Ha Halloween Show
NOT SURE - NEED TO CONSULT  

How many will be attending the event?

(Numbers only please)
*Ages of attendees: (20-40)

*How many presentations needed?

*What is the theme of the event?

Will you have other presenters at your event?

no yes If yes, how many?

Who are they?

Their topics?

*What is the objective of your event?

*How did your hear about Richard Paul? 

*Your Name  First and Last
*Your Mailing Address

Street

City

State

Zip
Phone (all numeric:  1231234567)
Home Work
Cell  
*Email:
*How would prefer to be contacted?
Email Work Phone
Home Phone Cell Phone
Mail  
Do you want to be on our mailing list? YES

NO

* Required fields  

THANK YOU!

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Richard Paul: 800-579-8051
Email: richard@richardpaul.com

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