Performer/Presenter Application Form Performer/Presenter Application Form Please note that completing this application does not guarantee that your program will be booked by any of our libraries. "*" indicates required fields Performer/Presenter Name and Pronouns* First Last Pronouns Organization or Group Organization or Group ContactIf different from performer/presenter. First Last Pronouns Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Phone*Email* Enter Email Confirm Email Preferred Method of Communication* Email Phone Text Message Have you or your group presented or performed at any TRL locations before?* Yes No Have you or your group presented or performed elsewhere before?* Yes No Performer/Presenter Background & Experience*Website (if available) Type of Program*Please selectPerformanceHands-on WorkshopDemonstrationTalk or LectureFacilitated DiscussionOtherProgram Title* Program Description*Audience Age Recommendation*Select all that apply. Babies and Toddlers (ages 0-2) Preschool (ages 3-6) School Ages (ages 6-11) Teen (ages 12-18) Adult (ages 18 and over) All Ages Program Duration* Equipment/Technology Requirements* Estimated Setup/Takedown Time* Maximum Number of Attendees*Performer/Presenter Availability*Please indicate the days of the week and time of day you are available to perform or present programs. Add additional rows for each day of the week. Day of WeekAvailability Add RemoveLocation Preferences*Select all that apply. Virtual/Online Indoors, Library Meeting Room Indoors, Library Main Space Outdoors, Library Grounds Outdoors, Community Location (e.g. park) Indoors, Off-site (e.g. Anywhere Library site visit) InsurancePlease note that you may be asked to provide proof of private commercial liability insurance before presenting library programs. Proof of private commercial liability insurance will be required for all performers who present library programs off of library property and for any library program that involves potentially dangerous elements (for example: live animals, science experiments involving potentially hazardous materials, performances involving props that could be dangerous, etc.).Do you currently have private commercial liability insurance or are you willing to obtain such insurance before presenting library programs should it be required?* Yes No Library Branch Location AvailabilityUse this section to indicate which libraries you are willing to travel to. Note that TRL covers five counties with 29 individual branch locations; consider travel distances when selecting! Review location details on our Hours & Locations page (accessible via the menu to the left). Click on “Map View” to show where our branches are located on a map for a sense of scaleHave you already been in contact with Timberland Library staff to present your program(s) at one or more of our branches?* Yes No Which Timberland Library (or libraries) are you in contact with currently?Type in the branch name or location in the box below. Please provide the name of the TRL staff person you are in contact with, if possible. I am available to present/perform at any TRL location*For virtual programs, select "Yes." Yes No (choose individual branches below) Grays Harbor County LibrariesSelect all that apply. Aberdeen Amanda Park Elma Hoquiam McCleary Montesano Oakville Westport Anywhere Library (Community Locations) Lewis County LibrariesSelect all that apply. Centralia Chehalis Mountain View (Randle) Packwood Salkum Winlock Anywhere Library (Community Locations) Mason County LibrariesSelect all that apply. Hoodsport North Mason (Belfair) Shelton Anywhere Library (Community Locations) Pacific County LibrariesSelect all that apply. Ilwaco Naselle Ocean Park Raymond South Bend Anywhere Library (Community Locations) Thurston County LibrariesSelect all that apply. Hawks Prairie Lacey Olympia Tenino Tumwater West Olympia Yelm Anywhere Library (Community Locations) Pricing Details/Fee Schedule*Please include travel expense fees/mileage if applicable. Please indicate the branch locations or distance radius from your “home base” that you will require mileage or travel expenses to visit. Program Goals*How will your program benefit members of the community, or what do you hope participants will gain or take away from experiencing your program?CAPTCHACommentsThis field is for validation purposes and should be left unchanged.
