Engagement and Arrangements Form The following is a confirmation of the engagement. Details of the arrangements shall be finalized following the Library’s receipt of this completed and signed form. Said form must be received by the Library at least two weeks prior to the engagement. **PLEASE NOTE, that in addition to this form you must also complete a W9 and an Indemnity Form. Follow the links at the bottom of this page. PAYMENT CANNOT BE PROCESSED if the Library does not receive all completed, signed, forms. Thank you.PLACE: Long Beach Public Library - 111 West Park Avenue, Long Beach, NY 11561 Note: The Library hours on Sundays are 1 p.m. - 5 p.m. - Tel: (516) 432-7201 Auditorium Doors will be open to the public 30 minutes prior to the beginning of the program. Please arrive early to set up. PLEASE NOTE: NO PROGRAM PRESENTER SHALL SELL, OR SOLICIT FOR, A PRODUCT OR SERVICE IN CONNECTION WITH THE PRESENTATION OF A LIBRARY PROGRAM. Please be advised that, as an independent contractor, you do not qualify for any benefits provided to the regular staff of the Long Beach Public Library. If you have to cancel this performance, please call the Programmer or the Reference Desk Librarian as soon as possible at 432-7201 or email the library at info@longbeachlibrary.org. Subject - Att: Cancellation of program. The staff of the Library may not be able to introduce your program; if this is a problem, please contact the programmer, at 516-432-7201.Date* Date Format: MM slash DD slash YYYY Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Website Person or Group*Program*Date of Appearance* Date Format: MM slash DD slash YYYY Time : HH MM AM PM FINANCIAL ARRANGEMENTS: FEE: Please submit a bill with your Social Security or Tax I.D. Number. No check can be issued without a bill and Social Security or Tax I.D.# and a completed and signed W-9 form. Please note: We will make every effort to compensate you in a timely fashion. However, we do not guarantee payment on the date of your performance. In order to process your check, we must receive a signed contract, a signed W-9 form and a signed Indemnity Form as soon as possible. Length of ProgramWill you need to schedule rehearsal time? Call 516-432-7201 to schedule.YesNoRoom Setup Chairs facing platform In a circle Other Special or other requirementsPlease check if you will be using: Piano Power Point Presentation Lectern Slide Projector Do you need copies of program material? If yes, please supply material 2 weeks prior Blackboard Tables Click here for printable Engagement and Arrangement Formopens in a new window Click here for Indemnity Formopens in a new window W9
