*1.Before completing this form, please confirm the following:(Required.)

You understand that submitting this form is not a guarantee that the library will be able to host/collaborate on your program.

You understand that planning programs takes time, and that the library usually requires at least 6-8 weeks from the initial proposal/meeting to the first date of the first proposed program. This allows time for admin, scheduling, and advertising. This means that a program submitted on July 1st would likely take place around August 12th-August 26th at the earliest.

*2.Contact Information (Name and Email)(Required.)

*3.Are you:(Required.)

An individual or group of individuals

A representative of a non-profit

A representative of a school group or club

*4.Proposed Program Title(s):
Please include name of program series as well as individual workshops. This can be a draft.(Required.)

*5.Learning Outcomes
What will participants learn from this program? Provide at least two.(Required.)

*6.Description of Program(s):
Please include the length of the program or program series, the ideal audience size, and a description of the presentation and/or activity.(Required.)

*7.Target Audience - Ages
Check all that apply(Required.)

Kids (6 to 8)

Older Elementary/Tweens (9 to 12)

Teen (13 to 17)

Adults (18 and older)

Older Adults (ages 55 and older)

*8.Do you need assistance with your program?
Check all that apply.(Required.)

I'd like to be paid for my time.

I'd like the library to help with (or provide) materials.

I'd like to volunteer my time and receive volunteer hours from the library.

I'd like to volunteer my time, but will receive volunteer hours from a non-library source.

Other (please specify)

*9.If you need funding assistance, what is the total cost of your program(s)?
Materials, presenter fee, etc.(Required.)

*10.What is your experience as a presenter or workshop leader/organizer?
Include expertise in the subject matter as well as teaching.(Required.)