Wufoo

The sponsor contribution is $50. How will you send in this contribution? *
We will be paying online. We will mail a check to Humanities Iowa, 100 Lib Rm 4039, Iowa City, IA 52242-1420.

Online payments can be made through JustGive.org at https://www.justgive.org/nonprofits/donate.jsp?ein=23-7374180.
Nonprofit Sponsoring Organization *
Organization's Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Organization's County
Name of Program Coordinator * First Last
Program Coordinator's Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Daytime Phone Number * ### - ### - ####
Email *
Program Information

Please fill out details for the proposed program.
Name of Speaker * First Last
Title of Presentation *
Have you contacted the speaker to ensure availability on the date needed? *
Yes No
Proposed Program Date * MM / DD / YYYY
What time will the program be held? *
Location of Program *
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Program Format
Banquet Conference Discussion Lecture Meeting Other
Estimated Attendance *

Programs must be held for 20 or more people.
Programs held in conjunction with a dinner or luncheon may ask attendees to pay the cost of the meal only. Do you agree to advertise the presentation as free and open to the public? *
Yes. Our organization agrees to advertise the presentation as free and open to the public.
How will you publicize to reach a general public audience? *
Organization's newsletter Organization's public calendar Radio advertisements Media releases Public Service Announcements Twitter Facebook Google+ Other

Check All That Apply
Please list the other ways you intend to advertise the program to the public.
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Wufoo

Program Information

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