Civics JotForm
Contact Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Organization Name:
*
Organization Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What type of organization are you?
*
Registered 501(c)(3)
Governmental Organization
Other type of Non-Profit, please specify
Partisan / nonpartisan action group
Other
Specify your type of Non-Profit
*
Location of meeting
*
Please Select
Birmingham
Heatherdowns
Holland
Kent
King Road
Lagrange
Locke
Main Library
Maumee
Mobile & Homebound Services
Mott
Oregon
Point Place
Reynolds Corners
Sanger
South
Sylvania
Toledo Heights
Washinton
Waterville
West Toledo
General demographic of the audience
*
Children
Teens
Adults
Date and Time of gathering
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Why is your group seeking a presentation on civic literacy from the Library?
*
What does your group hope to gain in receiving this presentation? Any particular topics you are hoping the presenter will cover?
*
Submit
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