Name of book Club (required)

Your Email (required)

Which day do you require to book our space?
Friday - after hours (5-7)
Saturday
9am-11am2pm-5pmOther
Other(specify):

How often do you meet?
Once a monthQuarterlyOther
Other(specify):

Number of people in your book club?
1-55-10Other
Other(specify):

Why should your book club be selected?

What impact is your book club making in society?

Would you like to be included in our newsletter mailing list?
YesNo