Outreach Program Request Form
Can't make it to the library? Complete this form and let us do the work!
Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
Email
*
If you don't have an email address, please enter Outreach@geaugalibrary.net
Method of contact
*
Phone
Email
Title/Organization
*
Event Name
*
Event Summary
*
Event Dates
*
-
Month
-
Day
Year
Date
Start & End Time
*
Event Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Estimated Attendance
*
Are there special/specific service interests for this event?
Would you like the Fun Bus to attend?
*
Yes
No
If so, where would you like it parked?
The Library's Fun Bus is a full box-size truck.
Are restrooms available for library staff?
*
Yes
No
Will there be free water or a drinking fountain available for library staff?
*
Yes
No
Additional Information
*
Please provide special instructions or comments for our Outreach Services, so they can provide the best services available.
Submit
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