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Library Program Proposal Form
General Information:
Name: ____________________________________ Date: __________________
Address:________________________________________________________________
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PHONE: ________________________________________________________________
E-MAIL: ________________________________________________________________
WEBSITE:______________________________________________________________
How do you prefer to be contacted (circle one): PHONE E-MAIL
Program Information
Title of Proposed Program_____________________________________________
Target Audience (circle applicable): Adults Teens Children Family (All Ages)
Program Description (you may attach additional information to this sheet):
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Estimated Attendance: ___________Estimated Length of performance:_____________
Have you previously presented a program at Westhampton Free Library? Y/N
Have you previously presented this program at any other location? Y/N If yes, where and
when?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
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Library Program Proposal Template
source: westhamptonlibrary.net
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