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2. Program Title
4. Preferred Date
5. Time
7. Second Choice Date
8. Time
10. Contact Person
12. Address1
14. Address2
16. City
17. State
18. Zip
20. Phone
21. Email Address
23. Program Description
25. Instructor's Qualifications (Degrees, Certificates, etc.)
27. Other Notes
29. PLEASE NOTE: The library’s program committee will evaluate your program based on its educational, informational, and recreational merit. Programs can NOT be promotional in nature or held with the intention of generating revenue. We will notify you in a timely manner if we decide to host your program.
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31. 1. Receive an email copy of this form.
32. Email address

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33. Submit Submit and Print

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