SEFLIN CLP Program Request Form

SEFLIN Committees and Discussion Groups are invited to recommend continuing education and training programs that may be presented through the SEFLIN CLP. To facilitate the request process, please use this form to make your suggestions. All data on the form must be entered. The form may be submitted to SEFLIN by the Committee Chair or the Discussion Group Leader (upon approval of the Discussion Group LAM liaison.)  Please submit the form online by clicking the "SUBMIT REQUEST" button at the bottom of the page.

Program Request

Name of Committee, Discussion Group, or SEFLIN member library/library system:

Program Title or Specific Topic:

Area(s) of Interest:

Program Speaker(s) Name(s) & Contact Information:

Program Description:

Describe the intended audience:

Describe how the program will meet the learning needs of library staff:

Type of room(s) needed(e.g. classroom or computer lab):

Length of Program: 1/2 day   full day   2 day   other If other, please explain:

Speaker Fee and Other Program Expenses(if known):

For Committees ONLY Date that this program was reviewed and recommended by the Committee:

For Discussion Groups ONLY Name of the Discussion Group's LAM liaison who reviewed and approved recommendation of this program:

For SEFLIN member library / library system ONLY List any group(s) (e.g. staff or committee) that reviewed and recommended this program:

Other comments:

Name of person submitting request:

Telephone:  xxx-xxx-xxxx

Email: