Program Proposal Application Program Proposal Application Please read our Programming Guidelines and Programming Proposal Guidelines before completing this form. One of our programmers will be in touch if you meet our requirements. Program Proposal Application Interested in having a program at the library? Please fill out the form to be considered. "*" indicates required fields Contact InformationName* First Last Email* PhoneAre you located in the tri-state area? (Kentucky, Ohio, Indiana) Yes No Does the presenter represent a private business or non-profit,?* Yes No If yes, please provide the name of your organization or business Presenter InformationSame as Contact Information above?* Yes No Presenter/Instructor NameIf no please complete presenter information fields. First Last Email PhoneProgram InformationProgram Title*This title may be altered by the library. Detailed Program Description*I understand and agree that my presentation will not include any form of solicitation or product/service sales or promotion Yes No If proposing a structured class (e.g. a computer class), please detail your prepared class outline or syllabus.Max. file size: 30 MB.If proposing a craft session, musical or theatrical performance, or other artistic endeavor, please provide links to photos/videos or social media sites which contain examples of your work.If proposing a book talk/signing, please share the title of the book and any supporting information (i.e., links to reviews, book chapter sample, etc.).Max. file size: 30 MB.Presenter's qualifications (Please list education/degrees, training, certifications, and/or experience the Presenter possesses that makes them qualified to present on this topic, or links to websites that show your experience or work.)Intended age group: (Select any that apply.) ** Children (Ages 0-2) Children (Ages 3-5) Children (Ages 5-8) Tweens (Ages 9-12) Teens (Ages 11-18) Adults (ages 18+) All Ages Program Duration* One Hour Two Hours Three Hours Other Other Duration Setup Time Needed* 30 Minutes One Hour Two Hours Other Other Set-up Time Needed If this program is a series, how many programs do you propose? Describe your preferred date/time/day of the week* Maximum attendance or registration limit for your program:* Equipment or supplies needed, including A/V or furniture (enter "n/a" if none):Space needed (describe any specific size or room features necessary)*Are you requesting a speaker/performance fee? * Yes No If yes, please describe your fee Have you or your group presented a program at the Kenton County Public Library before? * Yes No If yes, please provide the name of the library and the date(s)Have you or your group presented a program at a library other than the Kenton County Public Library?* Yes No If yes, please provide the name of the library and the date(s)References (i.e. contacts from other libraries or organizations where you've presented in the past)Please provide any additional information to help us evaluate your program proposal.Consent*By submitting below, I agree that I have read and will abide by the Programming Proposal Guidelines and the Library's Programming Guidelines and that the information I have submitted is correct to the best of my knowledge. I agree to the Programming Proposal GuidelinesCommentsThis field is for validation purposes and should be left unchanged. Can you tell me more about this webform submission? The contents of this webform are sent to library staff via email. We recommend that you do not submit confidential information (like your library card number, passwords or credit card information). If you need to share confidential information with library staff, we suggest that you use other channels of communication, such as the telephone.Visit our Privacy Statement, opens in a new window, opens a new window to learn more about how your personal information is handled and protected. Close This information will be submitted via email. Learn More about sending data over email.