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Category III: Limited Audience Program

This request form must be filled out completely - including signatures. There is a TWO application per calendar year limit for each organization and/or target audience. For first application include processing fee of $50 - or $75 for the following high use speakers: Jeff Barnes, Cherrie Beam-Callaway, Darrell Draper, Charlotte Endorf, Sue McLain, and Joan Wells. For second application, include processing fee of $100. Form and payment must be submitted at least 30 days before the program date. In addition to the processing fee, your organization is responsible for 50% of program cost, which will be determined by the HN office.

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Please include the name of building as well as a street address.

Have you confirmed date and time with speaker?

Home or organization address to which Humanities Nebraska should mail confirmation materials to you

I ASSURE THAT MY ORGANIZATION WILL:

  • Acknowledge HN funding in all print materials, media interviews, and at the beginning of the presentation,
  • Accept responsibility for 50% of program expenses and pay the speaker the day of the program,
  • Not charge a fee for the program (may charge for meals),
  • Display HN poster during the program in the room or at the entrance where the program is held,
  • Notify HN and the speaker immediately of any changes concerning the program (including cancellations),
  • Not use HN Speakers Bureau presentations as fundraisers, membership drives, or private gatherings, AND
  • Submit a final report within 10 days after the completion of the program.

I CONFIRM THAT:

  1. The organization requesting this program is a not-for-profit entity.
  2. I have read and understand the policies and procedures set forth by HN for this category.
  3. I understand that failure to comply with the above requirements may jeopardize my organization's eligibility for future programs and/or funding.
Payment Form

Please complete this form entirely before making your payment. A link to the online payment system is available at the end of this form. 

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PLEASE MAKE CHECK OUT TO:
HUMANITIES NEBRASKA


If you have any questions please contact our office by calling 402-474-2131 or emailing info@humanitiesnebraska.org. We are more than happy to provide any necessary assistance!

Humanities Nebraska programming is made possible by:

and generous individuals, foundations, and businesses across Nebraska.