Request for Inclusion in Lincoln Library's Community Calendar (Please print.)

Name of Event:

Organization Sponsoring Event:

Date of Event (Day, Month & Year):

Time of Event (Indicate a.m. or p.m.):

Place of Event (Include Street Address):

Is the event free? ______________ If not, indicate admission price. ________________

Brief Description of Event:

Phone Number for Public Inquiries for Additional Information:

(NOTE: This number will be included on the Community Calendar.)

Applicant Submitting Event:  __________________________________________

Phone: __________________________________________________ 

Signature of Applicant

 _____________________________________________________________________

Completed form can be submitted by . . .

FAX: (217) 753-4922                        MAIL:   Lincoln Library Community Calendar

                                                                            ATTN: Kim

                                                                            326 S. 7th St.

                                                                            Springfield IL 62701