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Patron Led Program Application

Patron Led Program Application

Please fill out this form if you are interested in teaching a program or hosting an event for the public at the Saline County Library. Once your form has been submitted, a staff member will review your request and contact you within 72 hours. You may also download a printable application.

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Applicant & Program Information

Your Name(Required)

First Last

Your Address(Required)

Street Address Address Line 2 City ZIP Code

Your Phone(Required)

Your Email Address(Required)

Enter Email Confirm Email

Preferred Method of Contact(Required)

Program Title(Required)

Are you requesting to be paid for your teaching services?(Required)

How much are you requesting to be paid per hour?

Are you expecting the Saline County Library to purchase supplies or reimburse your for supplies for this program?(Required)

How much do you expect supplies to cost?

How much do you expect to be reimbursed?

Indicate the kind of program you would like to present (check all that apply)(Required)

Baking/Cooking

Class/Workshop

Gaming

Lifestyle

Gardening

Health and Wellness

Arts and Crafts

Other

If other, please explain.

What age range is this program/event suited for?

0-5 years

6-9 years

10-12 years

13-18 years

Adults

Program/Event Description(Required)

Please describe the purpose and overview of the program. Include any topics covered and activities you anticipate doing.

Have you done similar presentations like this before?(Required)

If yes, please specify dates and locations below.

What are your qualifications for presenting the material?(Required)

Professional/Occupational

Hobbyist

Please describe your experience and qualifications below.(Required)

Number of years you have experience with this topic.(Required)

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Bob Herzfeld Memorial Library
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Benton, AR 72015
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Bryant, AR 72022
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