Richard Paul Assemblies

School Educational Speaker Richard Paul THE BULLY PREVENTER™

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

Click HERE for the following shows:
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:

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

* Required fields

THANK YOU!

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

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