For Book Clubs

Book Club Sign-Up

Share information about your book club to be eligible for an opportunity to have Elizabeth join your book club meeting by phone or video chat.

Group Name:

Contact Name

First:

Last:

Address:

(include apt/room/suite #)

City:

State:

Zip Code:

Country:

Phone:

Email:

type your complete email address:
ex. Your_Name@gmail.com, or
name@yourdomain.com an invalid
email address may cause your submission
to be lost.

Website:

Number of Women:

Number of Men:

approximate or average numbers are fine
if your membership is not consistent.

How old are the members in your group? Please select all that apply:

Ages:

Under 25
26-35
36-45
46-55
56-65
over 65

How long has your group been meeting?

Less than 1 year
1-5 years
5-10 years
More than 10 years

Where do you meet?

Please specify "Other"

How often do you meet? Please select all that apply

Weekly
Biweekly
Monthly
Bimonthly

Seasonally
Excluding summer months
Excluding December
Other

Please specify “Other”

Please share any other information about your group that can assist Elizabeth with interacting with your group.

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