| 1. NAME OF SCHOOL OR FACILITY: | |
| 2. Your name and title: | |
| 3. Your email address (please check for accuracy!) | |
| 4. DETAILED DESCRIPTION OF THE SERVICES COTTON WILL BE PROVIDING | |
| 5. Are you familiar with Cotton's presentation style? | |
| 6. IF "NO" PLEASE PROVIDE YOUR EXPECTATIONS | |
| 7. SCHOOL ADDRESS (STREET, CITY, ZIP) | |
| 8. FOR SINGLE BOOKINGS, PROVIDE DATE OF PROGRAM HERE | |
| 9. PROGRAM THEME | |
| 10. FOR MULTIPLE BOOKINGS, LIST FIRST AND SUCCESSIVE DATES/THEMES HERE | |
| 11. NUMBER OF PRESENTATIONS PER DATE | |
| 12. START TIME OF FIRST PROGRAM | |
| 13. TIME ALLOTMENT FOR EACH PROGRAM | |
| 15. YOUR QUOTE FOR COTTON'S SERVICES | |
| 14. END TIME OF COTTON'S LAST PROGRAM OF THE DAY | |
| 16. DO YOU NEED AN INVOICE? | |
| 17. FAX INVOICE TO | () - |
| 18. EMAIL INVOICE TO | |
| 19. SCHOOL CONTACT PERSON | |
| 20. CONTACT'S PHONE # | () - |
| PLAINCLOTHED PROGRAM? (Y/N) | |
| COSTUMED PRESENTATION? (Y/N) | |
| IF "YES", PLEASE SPECIFY COSTUME OF CHOICE | |
| AGE RANGE OF STUDENTS | |
| NUMBER OF STUDENTS ATTENDING | |
| WILL COTTON BE LOCATED IN THE SAME AREA FOR ALL PROGRAMS, WITH CLASSES COMING TO HER? (Y/N) | |
| WILL COTTON BE MOVING FROM CLASSROOM TO CLASSROOM? (Y/N) | |
| WILL AN ELECTRICAL OUTLET BE AVAILABLE FOR COTTON/S USE? (Y/N) | |
| DOES YOUR FACILITY OFFER SERVICES FOR STUDENTS WITH SPECIAL NEEDS? (Y/N) | |
| METHOD OF PAYMENT | |
| WILL THE PROGRAM BE HELD OUTSIDE? (If so, please share a rain contingency) | |
| IF YOU ANSWERED YES, WILL SHADE BE PROVIDED? | |
| DO YOU HAVE ANY STAFF MEMBERS WHO WOULD LIKE TO PARTICIPATE IN THE PROGRAM? | |
| IF SO, PLEASE PROVIDE NAME(S) | |
| COMMENTS & OTHER DETAILS | |
| DRIVING DIRECTIONS, IN YOUR OWN WORDS, TO YOUR LOCATION FROM RDU: | |
| DID YOU PROVIDE ADEQUATE DRIVING DIRECTIONS IN THE ABOVE FIELD? MAKE SURE ALL STEET NAMES ARE CLEARLY POSTED ALONG THIS ROUTE: (Y/N) | |
| DRIVING TIME FROM RDU | |
| PLEASE INCLUDE LANDMARKS AND EXACT DISTANCE BETWEEN EVERY TURN: | |
| PLEASE LIST ANY SPECIAL CONSIDERATIONS HERE | |
| IF PRIOR CONTACT IS DESIRED, PLEASE PROVIDE APPROPRIATE EMAIL ADDRESSES | |
| PLEASE TELL US HOW YOU BECAME AWARE OF COTTON'S EDUCATIONAL PROGRAMS: | |
| I HAVE READ COTTON'S CANCELLATION POLICY AND I AGREE TO COMPLY WITH ALL TERMS AS STATED: (Please initial) | |
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