Program Proposal Form

Name
Telephone
E-Mail
Mailing Address
Organization (if any)
Topic of Program
Program Title
Type of Program. Co-Sponsorship Library Supported
Please describe the program
Please describe the program goal and target audience
Who is presenting this program?
Presenter's Background
Why do you want to do this program?
Would you like to sell any material?

Have you read and do you understand the guidelines for co-sponsorship?
See Co-Sponsorship Guidelines. Yes No
Ideal time and date
Program length


Have you offered this program before? Yes No


Library Equipment Needed
Computer Projector Overhead Projector Laser Pen
Podium with Microphone VCR Dry Erase Board

Other (please specify):



Any required funding? Yes No