CBCPL Program Request Form

Program Request Form
Submitter Information
Name*

First NameLast Name
Email*
example@example.com
Are you submitting this request as someone who would like to LEARN about a given topic, skill, or experience or as someone who would like to PARTNER with the library in teaching about a given topic, skill, or experience?*

LearnerPartnerOther
Program Information
Program Age Group*

ChildrenTweensTeensAdultsSeniorsAll Ages
Program Category*

Book ClubS.T.E.M.Language & CultureArts & CraftsGamingFilm & TVOther
Preferred Day(s) of the Week*

SundayMondayTuesdayWednesdayThursdayFridaySaturday
Preferred Time(s) of Day*

Morning (9 a.m.-12 p.m.)Afternoon (12 p.m.-5 p.m.)Evening (5 p.m.-9 p.m.)
Please share specific day and time preferences here if needed.
Repeating Program*
Description of Program*
Should be Empty:

Program Request Form