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Program Proposal

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Name*
Phone*
Business or Stage Name
Email Address*
Website
Credentials/ Experience*
Will you be sharing information about or advertising a company or product in any way?*
1. Yes
2. No
Type of Program*
1. Adult
2. Children
3. Teen
4. Family
If yes, please explain
Title of Program*
Program Description*
Program Duration*
Max Number of Participants
Preferred Days and Times*
Preferred Location*
1. Esther Bone
2. Loma Colorado
3. Either Location
Do you charge a fee?*
1. Yes
2. No
Optional Documentation
If yes, fee amount