Submit a Program Proposal

First Name*

Last Name*

Organization Name* (If a company, please provide full name, as registered.)

Address*

City,State*

Zip Code*

Daytime Phone*

Email*

Website

Type of Organization
ProfitNot-for-ProfitGovernment AgencyIndividual

Description of Program

Do you have General Liability Insurance?*
YesNo

If yes, what is the amount of coverage?

Who is your main audience? *
Please note that special conditions apply to programs for children and teens.
Presenters will be asked to fulfill a number of requirements that may include
providing a background check.
Children (ages 0-12) and FamiliesTeens (ages 13-18)Adults (ages 19+)

Have you discussed this program with HPL staff?
If yes, name of person (if available)

Experience: Please list most recent work in past 3 years.

Have you provided programs at other libraries, or for other community
organizations? If yes, please list.....

Have you provided programs at HPL previously? Please list the 3 most recent
by name, location and date.

Does your program include any of the following (please check all that apply):
Health related infomationPhysical activityFinancial informationLegal InformationLive performanceAuthor

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