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Application to Hold a Program Using One of the Library’s Meeting Spaces

"*" indicates required fields

This field is for validation purposes and should be left unchanged.
Name*
MM slash DD slash YYYY
Beginning in June 2022, please use the Grade Level you will be in Fall 2022.
Which school will you be attending?*
Do you have a Garden City Public Library Card?*
Are you working with an organization, such as the Girl Scouts or Boy Scouts?*

Choose one.
Are you working with a parent or adult mentor on this project?*
Choose one.
If you chose "Yes" above, what is the name of the parent or adult mentor?
Is this project helping you toward earning a specific service award?*
Choose one.
MM slash DD slash YYYY
Are you required to fulfill a specific number of volunteer hours?*
Choose one.
MM slash DD slash YYYY
What is the target age range of your audience for your program?*
Check all that apply.
Will a parent or adult mentor be present with you during the duration of your program?*
Choose one.
How long would one session of your program run?*

If more than 180 minutes, please indicate the runtime of one session of your program
How many sessions would you like to hold of the program?*

If more than five, please indicate how many sessions..
Please provide a detailed outline of your program, including time increments for how long each activity in your program will last:
Activity
Time
 
Click the + sign to add rows as needed.
If your program involves an informational presentation, please list your specific sources below:
You 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 during your program?*
Choose one.
Drop files here or
Accepted file types: jpg, gif, png, pdf, Max. file size: 100 MB, Max. files: 10.
    All handouts must be included in your application.
    Do you need the Library to provide any of the materials listed above? (circle one)*
    Choose one.
    If Yes, please list the materials you need the Library to provide:
    Click the + sign to add rows as needed.
    Do you need use of any of the Library’s technical equipment for your program?
    Check all that apply.
    If you selected "Other" above, please list the equipment you are requesting:
    Click the + sign to add rows as needed.
    Do you have any potential days and times you would be available to hold this program?*
    Check all that apply.
    Can you be flexible with the date/time the program is held?*
    Choose one.

    References

    List three people who know you well enough to give information about you.
    Name*
    Reference 1
    Reference 1
    Reference 1
    Reference 1
    Name*
    Reference 2
    Reference 2
    Reference 2
    Reference 2
    Name*
    Reference 3
    Reference 3
    Reference 3
    Reference 3

    For Parent/Guardian

    I 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.*
    Parent's Name*
    MM slash DD slash YYYY