CAP Request for Children’s Program One Time Visit to a Library, School, Presentation, Community Venue or Event

Date of Requested Visit/Presentation/Event:

Time of Requested Visit/Presentation/Event:

Name of Facility/Organization:

Address:

Address Line 2:

City:

State:

Zip Code:

Email:

Phone:

Name of Contact:

Please describe your facility or the location of your event:

The Purpose of the Visit:

Please describe expected participants:

How many participants are expected:

Are you willing to publicize our visits

Internally at your facility?In your newsletter?On your website?In the local media?

CAP is an all volunteer organization. Visits are made possible through the generosity of members who give of their time, pay for their own training and pay annual membership dues. CAP must rely on the charitable contributions from the facilities that we visit or their "Friends Of" organizations. Are you able to make a periodic contribution?

YesNo