IPL Program Request Form
IMPORTANT: The Iberia Parish Library Programming Department will be in contact with you upon review if they decide to pursue the program further. Please note that turning in the form does NOT guarantee that your program will be accepted. You may also email supplemental materials that are related to the program. (I.E. video, photographs, letters of recommendation) to iberialibrary@gmail.com.
 **Note: If you are submitting a Request form for a craft or arts project, a photograph or scan of the craft/art must be emailed. No exceptions.
The subject header for the email should be the title of your proposed program and your/ your organizations name.
**Note: This form is not to be used for booking a meeting room. If you are interested in booking the meeting room for purposes other than a library-sponsored program, please contact the library branch location whose room you are interested. Booking a meeting room does require a $25.00 deposit with a check only. For further information on our library meeting room policies, please contact any of our branch locations. 
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Date (Date that this form is filled out) *
MM
/
DD
/
YYYY
Requesting Individual/Organization/Group *
Contact *
Email *
Physical Address *
Telephone *
Fax
Title of Program *
Anticipated Audience (#) *
Target Audience (age range appropriate for program) *
Required
Instructor/Speaker Topic(s) Proposed (If you have additional program requests, please fill out an additional form.) *
Instructor/Speaker Credentials *
Program Description *
Length of Program (I.E. 1 hour, 2 1/2 hours, etc...) *
Set-Up Time Required (I.E. 30 minutes, 1 hour, etc...) *
Supplies/Equipment Required *
Fee/Cost & Explain (if no fee or cost, answer N/A) *
Have you presented this program (or similar  programs) elsewhere? *
If so, please state where and which program
Days available for program (Please Provide several available days.) *
Required
Times available for program (please provide several available times.) *
Preferred Branch Location(s) *
Required
References that we may contact to inquire into your proposed program and credentials
I understand that completing this online program request form does NOT guarantee that my proposal will be accepted as a library sponsored program.  *
Required
Thank you for your interest in collaborating with your Iberia Parish Library.
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