Application to Have a Table to Provide Information or Collect Donations "*" indicates required fields CompanyThis field is for validation purposes and should be left unchanged.Name* First Last Date of Birth* MM slash DD slash YYYY Age*Grade Level*6789101112Beginning in June 2022, please use the Grade Level you will be in Fall 2022.Which school will you be attending?* Garden City Middle School Garden City High School Home Schooled Other If you chose "Other," please list your school:Email* Home Phone*Cell PhoneDo you have a Garden City Public Library Card?* Yes No Title of Project/Program:*Description of Project:*Are you working with an organization, such as the Girl Scouts or Boy Scouts?* Girl Scouts Boy Scouts No organization Other Choose one.Are you working with a parent or adult mentor on this project?* Yes No Choose one.If you chose "Yes" above, what is the name of the parent or adult mentor? First Last Is this project helping you toward earning a specific service award?* Yes No Choose one.If you chose "Yes" above, what is the name of the award?How many community service hours do you think you will need to complete this project?Which charity (or charities)/organization(s) does your Service Project/Program benefit?When does the project need to be completed?* MM slash DD slash YYYY Are you required to fulfill a specific number of volunteer hours?* Yes No Choose one.If you answered "Yes" above, how many volunteer hours are required?When do you have to complete the volunteer hours? MM slash DD slash YYYY Which Organization Requires the Hours?What is the target age range of your audience for your program?* Pre K Grades K-2 Grades 3-5 Grades 4-7 Grades 6-12 Ages 18-65 Ages 65+ Check all that apply.Will a parent or adult mentor be present with you during the duration of the time you are at the table?* Yes No Choose one.How many times would you like to have a table at the Library?* 1 2 3 4 5 Other If more than five, please indicate how many sessions..How long would one session at a table be?* 1 hour 2 hours 3 hours 4 hours Other If more than 4 hours, please indicate the runtime of one session of your programWill you be collecting donations at your table?* Yes No Choose one.If you answered "Yes" above, please name the charity that you will be collecting donations for:If you answered "Yes" above, please name the item(s) you will be collecting as donations: Add RemoveClick the + sign to add lines as needed.If you will be providing information at your table, please list your specific sources below: Add RemoveYou must include at least three sources. Click the + sign to add rows as needed. All sources must be included in your application.Will you be distributing handouts or other informational materials at your table?* Yes No If you answered "Yes" above, please upload your handouts with this application. All handouts must be included in your application. Drop files here or Select files Accepted file types: jpg, gif, png, pdf, Max. file size: 100 MB. All handouts must be included in your application.If your handouts are not created yet, please provide a detailed description of the handouts you plan to distribute:What materials are needed for your table?Do you need the Library to provide any of the materials listed above?* Yes No Choose one.If Yes, please list the materials you need the Library to provide: Add RemoveClick the + sign to add rows as needed.How many people will your table be able to serve?* 25 50 75 100 Other If you chose "Other," please specify a number.If you are distributing materials, how many people will you have materials for? 25 50 75 100 Other If you chose "Other," please specify a number.Tables are 6 ft. long. How many tables do you need set up?* 1 table 2 tables Other If more than 2 tables, please specify the number of tables you would need.How many chairs would you need for your table?* 1 chair 2 chairs 3 chairs 4 chairs Other If more than 4 chairs are needed, please specify the number of chairs you would need.Do you need use of any of the Library’s technical equipment at your table? Laptop Whiteboard iPads Other Check all that apply.If you selected "Other" above, please list the equipment you are requesting: Add RemoveClick the + sign to add rows as needed.Do you have any potential days and times you would be available to have a table?* Monday afternoons (3:00 PM - 6:00 PM) Monday evenings (6:00 PM - 9;00 PM) Tuesday afternoons (3:00 PM - 6:00 PM) Tuesday evenings (6:00 PM - 9:00 PM) Wednesday afternoons (3:00 PM - 6:00 PM) Wednesday evenings (6:00 PM - 9:00 PM) Thursday afternoons (3:00 PM - 6:00 PM) Thursday evenings (6:00 PM - 9:00 PM) Saturday mornings (10:00 AM - 1:00 PM) Saturday afternoons (1:00 PM - 4:00 PM) Sunday afternoons (1:00 PM - 4:00 PM) Check all that apply.Can you be flexible with the date/time the program is held?* Yes No Choose one.Is there anything else you would like us to know as we consider your application?How did you hear about the Teen Community Service Project Application?*ReferencesList three people who know you well enough to give information about you.Name* First Last Reference 1Email* Reference 1Phone*Reference 1Relationship to you:*Reference 1Name* First Last Reference 2Email* Reference 2Phone*Reference 2Relationship to you:*Reference 2Name* First Last Reference 3Email* Reference 3Phone*Reference 3Relationship to you:*Reference 3For Parent/GuardianI have thoroughly read my teen’s Teen Community Service Project Application and have given my teen permission to work on this Teen Community Service Project.* Yes Parent's Name* First Last Date* MM slash DD slash YYYY CAPTCHA Δ