1

Presenter Information

 *

Presenter Information

Name and Title

Name of Organization

Presenter Bio

2

Contact Information

 *

Contact Information

Street address

City, State, Zip Code

Phoneext.

Email address

3

Program Information

 *

Program Information

Suggested Event Title

Minimum enrollment

Maximum Enrollment

Program Duration

Description (The description should tell the audience what they'll see, hear, learn and do at the event and why they will want to attend. Describe your event in one or two sentences.)

4

Intended Audience

Intended Audience

Children	Intended Audience
Teens	Intended Audience
Families	Intended Audience
Adults	Intended Audience
55+	Intended Audience
All ages	Intended Audience

5

Equipment Required

Equipment Required

Projection	Equipment Required
Microphone	Equipment Required
Whiteboard	Equipment Required
Podium	Equipment Required
Tables	Equipment Required

6

Will you have a presentation? (We request that if you will be using our projector, that you bring your presentation on a flash drive to use with the library's laptop.)

Will you have a presentation? (We request that if you will be using our projector, that you bring your presentation on a flash drive to use with the library's laptop.)

YES	Will you have a presentation? (We request that if you will be using our projector, that you bring your presentation on a flash drive to use with the library's laptop.)
NO	Will you have a presentation? (We request that if you will be using our projector, that you bring your presentation on a flash drive to use with the library's laptop.)

7

Does your program suggestion require a fee for your presentation? (The library's budget is set the previous year. For most co-sponsored events at the library, the location and marketing is provided by the library and the presentation is donated or provided by a community partner.)

Does your program suggestion require a fee for your presentation? (The library's budget is set the previous year. For most co-sponsored events at the library, the location and marketing is provided by the library and the presentation is donated or provided by a community partner.)

YES	Does your program suggestion require a fee for your presentation? (The library's budget is set the previous year. For most co-sponsored events at the library, the location and marketing is provided by the library and the presentation is donated or provided by a community partner.)
NO	Does your program suggestion require a fee for your presentation? (The library's budget is set the previous year. For most co-sponsored events at the library, the location and marketing is provided by the library and the presentation is donated or provided by a community partner.)

8

If your program suggestion requires a fee, what is the cost?

If your program suggestion requires a fee, what is the cost?

9

Available Dates and Times for Scheduling 

 *

e.g. specific date/dates, weekends only, morning/days referred etc.

10

Additional Info

Is there anything else you would like us to know about your program idea?

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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