Date of event:

Type of event:

City of event:
Time of day for appearance:
Place (venue) of event:
Name of organization:
Organization phone number:
Is this an annual event? yes no
If yes, how many years has this event been held?
Names of other special guests and attractions:
Price of admission to event:

Describe exactly what you are requesting of Dr. Turner:
Your name:
Your email address:
Your phone number: