FULL REQUEST EVENT FORM

Fill out as many items as you can. Items with an asterisk * are required.

A. BASIC INFORMATION

A1. Your First Name.*

A2. Your Last Name.*

A3. Your work or primary email address.*

A4. Confirm email address.*

A5. Name of the institution.*

A6. Street address of the institution.*

A6a.Street Address *    

A6b. Second Line for Address *    

A6c. Third Line for Address  

A6d. State/County*   

A6e. Country*    

  United States of America Puerto Rico Hawaii Other USA territories

This form is only valid to book events for the United States and its territories.

A6f. Zip Code*    

A7. Does your organization have a website?*

YES NO

A8. If yes, enter the website address. (Use the complete path, like this:
http://www.shamansdance.com)

A8. What is your title within the organization?*

A9. Are you authorized to request an event?*

YES NO

A10. Are you authorized to negotiate and event?*

YES NO

A11. Will you be making the final decision or will someone else will?*

I will make the final decision. I will pass the information and someone else will make the final decision.

A13. Your phone number at work*

A14. Confirm your phone number

B. ORGANIZATIONAL PROFILE

B1. Type of institution. (Choose all that apply.)* .

Art venue Professional membership organization. Organizational membership or coalition. Local chapter of national non-profit. Book Club. OTHER (Specify in the field below). Community service organization Cultural center College or higher learning institution Adult education center Public school, elementary Public school, junior high Public school, high school Special Conference or Symposia Organization providing sanctuary or refuge to women and families. Women services Family Services Children services. Youth services. Elder services. Violence prevention services. Advocacy organization. Private school. Parent association. Student Association. Bilingual Program.

B2. Other (If not listed above, please specify.)

B3. Your constituency. (Choose all that apply.)*

Women People of color. Children. Youth. Members. Parents. Families. Latinos. Multicultural. Professional membership. Local communities. Other organizations-Coalition members OTHER (Specify on field below.) Student members.

B4. Other. (If not listed above, please specify.)

B5. Do you already have the funds to pay the presenters' fees?*

(If you do not have funds for fees, you are required to answer Items C12 through C16)

YES NO.

C. EVENT PROFILE

C1. What type of art event are you interested in presenting?*

What type of event do you want from us? Art performance. Lecture. Literary Reading. Workshop. Interactive Community Event. A Healing-Through-the-Arts Journey An Arts-in-Education Event for school Dont know yet. I would like to brainstorm with you. OTHER. (Specify in the field below.)

C2. Other. (If not listed above, please specify.)

C3. Which of our artists are you requesting?*

Maria Mar Corazon Tierra Both of you.

C4. To what Creative Collection or book is this event related?*

Choose the book or Creative Collection for your event Beloved BodySoul Collection Bewomaning Collection The Little Sol Collection BOOK-Almost Disappearing-novel BOOK-ANA DANZA novels BOOK- At the End of my Curls There is a Rainbow Coleccion CuerpoAdentro (Spanish) Coleccion La Pequena Sol (Spanish) LIBRO-Casi desaparecida-novela LIBRO- En la punta de mis rizos hay un arcoiris. Dont know.

C5. In what language do you want our presentation?*

English Spanish.

C6. What type of event do you want?*

A stand-alone art performance. Choose the type of event you are presenting. A stand-alone lecture. A stand-alone reading. A stand-alone workshop. A stand-alone interactive-community event A one-day Healing-Through-the Arts-Journey. A week-end Healing-Through-the-Arts Journey A lecture as part of a larger event. A reading as part of a larger event. A workshop as part of a larger event. An art performance as part of a larger event. A fundraising event featuring your event. A fundraising event including your event and others. A banquet with you as a guest event. A literary soiree or other literary activity. A gala art event featuring you. A gala art event including you and others. A school event. A members only event. OTHER. (Specify in the field below.)

C7. If this event is already scheduled, what is the date of the activity?

C8. If this event is to be scheduled, what date would you prefer?

C8a. Option 1 Date*   

C8b. Option 2 Date   

C8c. Option 3 Date   

C9. Who will attend this event? Choose all that apply.*

Describe your audience The general public. Open to the community. Members only. Our members and their families and guests. Students only. Women only. Parents only. Staff only. Our clients and their families. For small program group. Staff and board. Board retreat. By registration only. OTHER

C10. How many people do you expect will attend this event? Choose one.*

25 or less 25 to 50 50 to 100 100 to 150 150 to 200 200 to 300 300 to 500 500 to 750 750 to 1000 1000 to 1500 1500 to 3000 3000 to 5000 5000 to 7500 7500 to 10,000 More than 10,000

CHOOSE YOUR NEXT SECTION:   

YOUR COMMENTS              SUBMIT            FEE-WAIVING REQUESTS

D. FEE-WAIVING REQUESTS.

If you are requesting us to waive our fee for the event, you are REQUIRED to fill this section. Be aware that:

1. Only readings and lectures are offered pro-bono.

2. We can only waive our fee once for an institution.

3. We can only waive our fee for a non-profit institution.

4. You will need to pre-pay all travel, room and board costs for the event, and to cover the cost for any interactive material we use during the presentation, such as an interactive-mini kit or participation form.

5. You will need to offer us some non-monetary benefit in exchange for waiving our fees.
   Items C14 through C16 give you an idea of your bartering power.

C11. Are you requesting us to waive the fee for our presentation?*

NO. YES

C12. Will you be charging the audience or is this a free event?*

This is a free event. This event is part of our regular programming and at no charge to participants. This is a fundraiser and we will be charging. We will be charging our members only. We will be charging everyone. We will be doing fundraising to provide the event freely.

C13. Is this a fundraiser?*

YES NO

What benefits can you offer us in exchange for waiving our fees?

The next items give you an idea. Choose the ones that fit your institution's capabilities.

C14. Do you have any of these facilities or services for us during the event?*

(If you are requesting a pro-bono event, consider these items as your leverage.
The more items from these list you provide, the better your changes
that we will do a pro-bono event for your organization.)

We can offer the following facilities for you at the event. Professional photography of event Professional video taping of the event. Professional audio taping of the event. Send professionally written press releases to national press. Send professionally written press releases through wire services. We will write a letter of referral for you. We will record an autio testimonial for you. We can purchase your eproducts or services for our training. We can set a table to sell and promote your services and products at the event. You can announce your products and services during your presentation. We can pay you for a training or other follo-up event after the speaking. We can become your egreeting partners to send the egreetings with a cause. We are willing to discuss other ways in which you can benefit from presenting pro-bono. Will commit to booking you for a paying event next year. Will place a webpage about you and the event in our website. Will join your organizational network. Will give you a number of tickets or seats for your guests. National TV is covering this event. We are booking radio coverage for this event. We present or will be featured in a cable TV about this event. We will send your newsletter or other marketing material to our client list.

C15. What type of publicity/outreach will you do for this event?*

We can generate the following publicity for you and the event. This event requires no publicity because it is in-house. We hire a publicist for this event. Send press release to local press. Send professionally written press releases to national press. Send professionally written press releases to national wire services. Send email to all our data base. Take photos to send to press after the event. We can tape a rehearsal or interview with you and place it in TV. We can book a radio show for you. We have our own cable show where you will be featured. We have magazines contacts and can feature you in a magazine. We have media contacts and can feature your profile in newspaper. We do ample publicity for our event every year through a dedicated staff or consultant. Our organizational network expands our publicity efforts.

C16. Do you have an event coordinator, host or other liaison
who will work with us before, during and after the event?*

YES, There will be an event planner handling this event. YES, one of our staff handles this event. YES, we will assign a VOLUNTEER to contact you and oversee the event. NO. We do not have the capacity to assign a special person to oversee this event.

End of Fee-Waiving Section. Continue to next item.

C17. Please describe the event as it takes place every year, or the event you envision. This is a place to let us know what you would like, the mood, the purpose, your organizational goals, who you have presented before and everything that can help us ascertain how we can best help you.*

I am requesting an event at a preliminary stage.

My institution is making no commitment to contract you

and we understand that we do not have to pay any fees until a contract is signed.

The information that I provide here is confidential and accurate and I am authorized to provide it.

Our privacy and confidentiality policy is 100%.
We will not give out your address or any part of your information
to anyone under any circumstance.

Problems filling out this form?

EMAIL US!

QUICK REQUEST FORM

All fields are required.

Your First Name

Your Last Name

Name of institution

Contact Email Address

Confirm Email Address

Contact Phone Number

Confirm Phone Number

What type of event do you want?

Choose the type of event you want from us. Art Performance Lecture Literary Reading Interactive Community Art Event Workshop Healing-through-the-arts Journey Arts-in-Education Event Do not know. OTHER.

From what collection or book or by what artist would you like to request an event?

Choose the collection, book or artist for your event. Beloved BodySoul Collection-women and girls BOOK- Almost Disappearing-novel about healing anorexia artist-Corazon Tierra artist-shaman Maria Mar Bewomaning Collection-women and their families BOOK-Ana Danza novels-the female face of power The Little Sol Collection-children and parents BOOK-At the End of my Curls-novel-children and their families ESPANOL-Coleccion CuerpoAdentro-mujeres y jovencitas ESPANOL-Casi Desaparecida-novela sobre sanacion de anorexia ESPANOL- Coleccion La Pequena Sol-Ninos y sus padres ESPANOL- En la Punta de mis rizos-Novela para ninos y sus padres I DO NOT KNOW

Your comments or questions.

I am requesting an event at a preliminary stage.

My institution is making no commitment to contract you

and we understand that we do not have to pay any fees until a contract is signed.

The information that I provide here is confidential and accurate and I am authorized to provide it.

Our privacy and confidentiality policy is 100%.
We will not give out your address or any part of your information
to anyone under any circumstance.

Problems filling out this form?

EMAIL US!