Special Member Event Proposal

Event Title: (Character Limit of 65.) *

Presenter Name *

First Name Last Name

Presenter E-mail (Please expect all correspondence to take place by e-mail): *

Presenter Address *

Street Address

Street Address Line 2

City State

Zip Code

Presenter Phone Number *

Area Code Phone Number

Additional Presenter? *

Yes - there will be an additional presenter No - there will not be an additional presenter

Additional Presenter Name *

First Name Last Name

Additional Presenter Email *

example@example.com

Additional Presenter Address *

Street Address

Street Address Line 2

City State

Zip Code

Additional Presenter Phone Number *

Area Code Phone Number

MOLLI is using all of the following teaching platforms during each term. Please select all platforms you are willing and/or able to use. *

In-Person Only (Selection of this option may result in your event being postponed until a later term unless this event will take place outdoors.) Remote Only Hybrid (Students synchronously attending in-person or remotely)

Select the session you would like to present: *

Winter 2022 [Dec 1, 2021 - March 31, 2022] - Deadline to submit proposal: October 15, 2021 Spring/Summer 2022 [April 1 - June 30, 2022] - Deadline to submit proposal: November 15, 2021 Fall 2022 [Aug 1 - Nov. 30, 2022] - Deadline to submit proposal: May 15, 2022 Winter 2023 [Dec 1, 2022 - March 31, 2023] - Deadline to submit proposal: September 15, 2022

Event Format *

Speaker Performance Film Demonstration Other

MOLLI Event Information

Our events typically run for 90 minutes. Presenters should be prepared to present for 60 to 80 minutes and allow time for questions. Please provide the following:

Topic and Explanation of the Educational Value and Benefit to Lifelong Learning. *

Description of topic and explanation of the educational value and benefit to lifelong learning, or in some circumstances, to community building. If you have presented this material previously, through MOLLI or elsewhere, please describe where and when.

Marketing Description of Event (125 word limit). *

0/125

Please provide presenter biography for the MOLLI catalog. *

65 Word Limit 0/65

Please provide additional presenter biography for the MOLLI catalog. *

65 Word Limit 0/65

Comments: (special travel arrangements, special or unusual equipment, additional expenses, scheduling issues, etc.)

65 Word Limit 0/65

Please Note:

Presenters are not allowed to promote any product or partisan position. Additional specific scheduling information will be required by the MOLLI office if the event is approved.