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Digital Library
Browse
Events
Get a Library Card
Printing
Hours & Locations
Event Submission
Event Submission
Community submissions for future events.
"
*
" indicates required fields
Presenter/Performer Information
Program presenter/performer name
*
First
Last
Email
*
Phone
*
Virtual numbers accepted (WhatsApp, Telegram, Signal, etc)
Organization
Website
Representative/application submitter name and contact information
If different from above
Contact Preference
*
Who would you prefer us to contact?
Contact presenter/performer directly
Contact representative/application submitter
Equity Self-Identification Survey
The information collected is confidential and will be used on an aggregated basis. Your information will help us to prevent or address systemic barriers to access and opportunity, set and promote equity, diversity and inclusion goals, measure progress and improve the recruitment experience for all applicants. You may self-identify under more than one of the designated groups. Your responses will not negatively influence our assessment of your proposal. Definitions of the designated groups found below are provided by Statistics Canada.
Participation
*
Do you wish to take part in the Equity Self-Identification Survey? This survey is optional.
Yes
No
Visible Minority (racialized)
Are persons, other than Aboriginal peoples, who are non-Caucasian in race or non-white in colour, regardless of birthplace.
Arab
Black (e.g., African, American, Canadian, Caribbean
Non-White West Asian (e.g., Iranian, Lebanese, Afghan)
South Asian/West Indian (e.g., Pakistani, Indian, Bangladeshi, Guyanese, Trinidadian, Sri Lankan, East African)
South East Asian (e.g., Burmese, Cambodian/Kampuchean, Laotian, Malaysian, Thai, Vietnamese, Indonesian)
South East Asian (e.g., Burmese, Cambodian/Kampuchean, Laotian, Malaysian, Thai, Vietnamese, Indonesian)
East Asian (e.g. Chinese, Japanese, Filipino)
Latin American
Persons of Mixed Origin
Other
Not a visible minority
Persons with disabilities
Are those that have a long-term or recurring physical, mental, sensory, psychiatric or learning impairment and who: a) consider themselves to be at a disadvantage in employment by reason of that impairment, or b) believe that an employer or potential employer is likely to consider them to be disadvantaged in employment by reason of that impairment. This also includes persons whose functional limitations owing to their impairment have been accommodated in their current job or workplace.
Yes
No
Prefer not to answer
Aboriginal (Indigenous) person
North American Indian, Métis, or Inuit and/or a Treaty Indian or a Registered Indian and/or member of an Indian Band/First Nation. Based on this definition, are you an Aboriginal (indigenous) person?
Yes
No
Prefer not to answer
LGBTQ2S+
LGBTQ2S+ is an acronym for persons who identify, for example as, lesbian, gay, bisexual, transgender, two-spirited, genderqueer, questioning, or who otherwise express gender or sexual diversity. Do you identify as LGBTQ2S+?
Yes
No
Prefer not to answer
About Your Program
Type of Program
*
Author Talk
Lecture/Presentation
"In conversation with..."/Panel
Film Screening
Performance/Theatre
Workshop
Other
Program Description
*
(2500 characters or less)
Program Outline
*
Please provide an outline of what will occur during the program and any materials (i.e., books, etc.) that you plan to use. Include all activities that will be conducted during the program. If this program is specifically designed for persons with disabilities, please provide specific examples of how the program has been developed for this audience.
What can participants expect to gain from this program?
*
Alignment with the Library’s Strategic Plan
*
2019-2023 Library Strategic Plan: https://pickeringlibrary.ca/wp-content/uploads/sites/76/2019/08/Strategic-Plan-Public-Version.pdf
Lifelong learning, early literacy and culture of reading
Access to technology, digital learning
Support financial success
Empower community’s physical, social and mental well-being
Inclusion and belonging
Select All
Target Audience
*
Children (0-5)
Children (6-12)
Youth (13-17)
Adults (18-24)
Adults (25-64)
Adults (65+)
Program Cycle
*
Summer
Fall
Winter
Spring
Anytime of the year
Other (You may indicate if this program is time sensitive and for what period of time. For example, if you are only in town during a specific time.)
Other
Please list when you would like to run this program and why
Program Duration
*
Include time needed for a question period.
30 minutes
60 minutes
90 minutes
Other
Optimal number of program participants
*
Note: attendance size is not guaranteed.
Preferred
Minimum
Maximum
Fee
*
Consider and include all costs such as materials/supplies and travel. You may suggest a fee range. Indicate if your fee includes HST.
None; offered to library at no charge
This program is grant funded
Amount (please specify)
Amount
Technology needed
*
To be provided by the library
Microphone
Television/Screen
Laptop
Projector
Podium/Lectern
DVD Player
Other
Other
Will this event be offered in-person, virtual, or hybrid?
Hybrid events are presented both in-person and virtually over Zoom or other video conferences platform.
In-person
Virtual
Hybrid
Will your program involve live animals?
*
Yes
No
Do you have any related materials or services that you will highlight, give away, or sell during the program?
*
Yes
No
If 'Yes', list the items you will be giving away:
Related Materials
Is your material (book, ebook, DVD, CD) available for borrowing from Pickering Public Library?
Yes
No
Unsure
Not applicable
Is your material self-published?
Yes
No
Not applicable
Copyright
I acknowledge I have permission to publicly share the materials contributed and do so in compliance with any copyright and permissions for all materials brought forward?
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Presenter Experience
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Do you have any training or education in this field?
*
Yes
No
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If yes, please specify
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Do you have experience delivering programs to the indicated target audience(s)?
*
Yes
No
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Previous experience
If you have previous experience delivering the program, please list the dates and locations below.
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References
Please list 2 professional references. References may include organizations who have hosted your program or individuals to whom you have delivered this program or a similar program. If your program is specifically designed for persons with disabilities, please provide a reference who can attest to your experience with this group. Please advise your references that they may be contacted by the Pickering Public Library.
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Reference 1
First
Last
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Email
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Phone
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Organization
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Relationship to presenter
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Reference 2
First
Last
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Email
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Phone
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Organization
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Relationship to presenter
Policy
Programming Policy
*
I have read and accepted the terms of the Programming Policy.
Guarantee
*
I understand that submitting this application does not guarantee that I will be matched with a library branch.
Materials costs
*
I understand that I may be responsible for my own material costs.
Pickering Public Library can edit program title and description
*
I understand that Pickering Public Library reserves the right to edit activity titles and descriptions for length and content.
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Photo or Video
*
I give permission to be photographed and/or videotaped for Pickering Public Library promotional and educational purposes and materials.
Yes
No
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.
