Program Presenter Application

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* 1. Presenter Information

Name:

Name of Act:

Address:

City:

State:

Zip Code:

Home Phone:

Cell Phone:

Work Phone:

FAX:

Email:

Website:

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* 2. Program Information

Subject/Name of Program:

Program type (lecture, workshop, film, discussion, author talk, performance):

Length of presentation:

Number of people you can accommodate:

Cost of Program:

Availability (dates/times):

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* 3. Have you presented this program before?

Where:

What age groups:

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* 4. Experience/training/credentials in subject area(s)

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* 5. Would you be willing to present this program at multiple pioneer Library System locations?

Yes

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* 6. Types of presentation equipment and/or audio-visual equipment needed (podium, microphone, projector, internet):

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* 7. Other accommodations required:

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* 8. Other Information you would like to provide:

Supporting Documentation:
Please send any supporting documentation (resume, review copy of book, film, musical cassette, promotional materials, newspaper/magazine reviews, letters of recommendation) to Galyn Hembree, coordinator for system programming for PLS, at galynh@pioneerlibrarysystem.org or 300 Norman Center Court Norman, OK 73072