Name
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First Name
Last Name
Phone
*
(###)
###
####
Email
*
Working title of your presentation:
*
Date and time of your presentation:
*
Name of your program manager:
Short biography:
How would you like your name to appear in publicity materials?
*
How would you like to be addressed during the presentation?
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Projector
*
No, I will not need to use the projector.
Yes, I will need to use the projector.
Display Items
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No, I will not be bringing any display items.
Yes, I will be bringing some display items.
Pamphlets / Handouts
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No, I will not bring any handouts.
Yes, I will have literature available for audience members.
Honorarium
*
I will accept the honorarium ($100).
I would like to donate the honorarium to the Library.
Can you suggest any organizations or individuals who may be able to assist us in publicizing your event?
Library Recording: Our programs are often offered in a hybrid model using Zoom Meetings. May we record your presentation for viewing by those who signed up for your presentation?
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Yes, you may share a recording of my presentation with the people who signed up for the presentation.
No, I do not want the Library to make a recording of my presentaion.
Town Recording: It is sometimes the case that the Town of Brewster records our presentations. They will make the video available to the public on the Town's webiste.
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Yes, the Town of Brewster may record and share a video of my presentation.
No, I do not want the Town of Brewster to record my presentation..