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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!


If you are making an online payment, you will be directed to that page after clicking "Submit" above. Your application will not be saved until you click "Submit." 

Humanities Nebraska programming is made possible by:

and generous individuals, foundations, and businesses across Nebraska.