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Booking Request

Thank you for your interest in booking the Philly Youth Poetry Movement! Please complete the following information needed about your event. We will review the information and respond as soon as possible to confirm our availability.

Note: While PYPM offers great programs and workshops for free to Philadelphia area youth, requests for special performances and workshops are subject to an honorarium fee to cover associated expenses and artist/facilitator stipends.

Booking Request*
 PYPM Performance only  
 PYPM Workshop only 
 PYPM Performance & Workshop 
 
Name of Event*
 
Event Topic/Theme*
 
Event Description*
 
Date of Event*

MM		 /
DD		 /
YYYY
 
Event Start Time*

HH		 :
MM		  
AM/PM
 
Event End Time*

HH		 :
MM		  
AM/PM
 
Are you requesting
PYPM for entire event?
 Yes, entire event 
 No, partial event appearance 
 
Event Location*
 
Location Address*

Street Address

Address Line 2

City
State / Province / Region

Postal / Zip Code
Country
 
# of Poets Requested*
 
Expected Audience
(Description: Demographic, Age
Group, # Attending)*
 
Contact Name*

First
Last
 
Contact Email*
 
Contact Phone Number*

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