Prairielands Author Grant Application
Applicants MUST be a partnership between at least 1 public library and 1 school library.
Public Library Name:
Applicant Name:
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Email
example@example.com
School Library Name:
School Contact Name:
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Email
example@example.com
Who is the main contact for this program?
Public Library Director
School Librarian
Neither
Main Contact:
First Name
Last Name
Have you contacted an author yet?
Yes
No
Name of author contacted:
First Name
Last Name
*Prairielands strongly recommends checking with an author for availability and fee before applying for this grant.* Proposed date(s) of Author visit:
-
Month
-
Day
Year
Date
List other sources of funds, if any:
Budget Information: Author Honorarium:
Travel:
Facility Rental:
Advertising:
Materials for Program:
Equipment:
Total Expense Amount:
Amount Requested (not to exceed $1,000)
Paid receipts required within 30 days of event for reimbursement.
Submit
Should be Empty: