Program Proposal Form

Program Proposal Form
Your Full Name*

First NameLast Name
Your Organization (if applicable)
Organization or business website (if applicable)
Type of organization*

IndividualNonprofit/community organizationFor profit businessOther
Your Email Address*
example@example.com
Your Phone Number*
Please enter a valid phone number.
Your Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Presenter's Expertise/Credentials
Proposed Program Title*
Proposed Program Description*
Primary Intended Audience for Program*

AdultsTeensSchool Age Children (Ages 6-11)Pre K Children (Ages 0-5)All Ages
If you are presenting a program for children or teens does the presenter have all required clearances? (child abuse, criminal history check, FBI)?*

YesNoN/A
How long is your program? (e.g. 45 minutes)*
This program works best as*

a one time programa seriesan ongoing recurring program
Proposed dates and times (please keep in mind some of our programming schedules run 3-6 months ahead).*
How will registration be handled?*

I would like the library to handle registrationNo registration required
Required Resources and Equipment*
Have you presented this program at other libraries? If yes, please share where you have presented and provide contact information for references, if possible.
Please share any other details about you or your program.
Upload a flyer for your event if you have one you would like us to use.

Cancelof
I have read the mission statement and program policy and my proposed program is in line with both.*

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