Newbury Town Library Program Presenter Agreement Presenter InformationFirst Name* Last Name* Phone NumberEmail Home Address Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Program InformationProgram Title* Is this program virtual?* Yes No Program Description* Month Day Year Program Date* Month Day Year Time of Event* Time of Arrival Before Event* Agreed Upon Fee* Please Indicate What Type of Equipment You Need Projector Laptop Speakers Easel Podium Other Please Specify* W9 Form Sent?* Yes No Depending on how this event is being paid for, a check, payable to the presenter will be either:* Mailed to you at the above address within 30 days after the event Provided on the day of the program Please attach the following: A one paragraph bio A one paragraph description of your program A publicity photo Upload Files Drop files here or Select files Max. file size: 50 MB. If you are an author or performer, check here if you would like to sell and sign your books, CDs or DVDs after the event. (Please bring your own copies of the book, CD or DVD as well as change and a sign with the book’s price, unless you have made other arrangements in advance.) Library policy requires 5% of all sales to be given to the Friends of the Library. You may display business cards, brochures, or similar information for attendees to take, but neither business solicitation nor fundraising for nonprofits should be part of the program. In the event that either the Newbury Town Library or the presenter is unable to make, or must cancel the scheduled program, both the library and the presenter will make every effort to reschedule at a future, mutually convenient date and time.Please Check All that Apply I agree to allow the Newbury Town Library to take photos of this event and use them on their website and social networking pages. Please do not take photos of this event. I agree to allow Newbury’s cable educational cable TV channel to record this program (if available). Please do not record my program. NameThis field is for validation purposes and should be left unchanged. Δ
