xAForm-AOM

Authors On The Map Breakfast

Each featured author will receive up to TWO free breakfast tickets to PNBA’s Authors on the Map, one for the author and one for the author’s escort, spouse or colleague. We will hold the tickets for pick up with the badges, when the author arrives at the show. If the author would like any special accommodations at the event, you may also note that on this form.

Complete and send this form as soon as possible and no later than Friday, August 19

Featured Author Information Form

Authors On The Map Breakfast

* Indicates required field

Author Name *

First

Last

Personal Pronoun (optional) *

Book Title *

Publisher *

Publisher Contact *

Publisher Contact Email *

Publisher Billing Contact *

Billing Contact Email *

Author Photo: *

JPG, PNG or GIF

Author's Meal Choice: *

Grab 'n' Go

Escort/Guest Name *

Personal Pronoun (optional) *

Escort/Guest Meal Choice: *

Grab 'n' Go

Special Requests *

Submit

Authors On The Map Breakfast

Featured Author Information FormAuthors On The Map Breakfast

Featured Author Information Form

Authors On The Map Breakfast