2019-2020 PRIME TIME Program Application

Applicant Agency, Site, and Program Information

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* 1. Enter the name of the entity or organization this PRIME TIME program is an affiliate of or serves as a major branch. (i.e. state or regional library, individual library, school system, individual school, etc.)

Example: Birmingham City Schools for Huffman Academy; Birmingham Public Library for Inglenook Branch Library

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* 2. Host Site: Please enter the name of the host site.

Host Site *

Host Site Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Site Web Address *

Site Phone Number *

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* 3. Please identify the county in which your Prime Time program will take place.

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* 4. Program Type: Click to indicate which type of PRIME TIME program(s) this site will implement.

For more information about program types, visit the following websites:

PRIME TIME Family Reading Time:
https://www.primetimefamily.org/family-reading-time/

PRIME TIME Preschool:
https://www.primetimefamily.org/preschool/

PRIME TIME Preschool (3 to 5 year-olds)

PRIME TIME Family Reading Time (6 to 10 year-olds)

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* 5. PRIME TIME Term: Please enter the term(s) during which you would like to host your PRIME TIME program.

Fall (Fall program dates should be set between August and December.)

Spring (Spring program dates should be set between January and June.)

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* 6. Fall Program Dates: Please enter the planned dates and prospective times of your program.

First Choice Date / Time

Date

Time

AM/PM

Second Choice Date / Time

Date

Time

AM/PM

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* 7. Spring Program Dates: Please enter the planned dates and prospective times of your program.

First Choice Date / Time

Date

Time

AM/PM

Second Choice Date / Time

Date

Time

AM/PM