SAGE NYC - SAGE Centers - Programming Proposal Form

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Programming Proposal Form

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First Name*	Last Name*


Organization Name (if applicable)


Street Address	Line Two


City	State	Zip


Email*	Phone*


Please briefly describe the program you propose leading at SAGE* Are you interested in providing this program on a voluntary basis?* Yes No What is the goal of the program as it relates to SAGE's mission of healthy, active aging in community? What can our participants gain from attending this program?* What are your qualifications or credentials for producing this program?* SAGE is an organization that works with Gay, Lesbian, Bisexual and Transgender elders. What experience, if any, do you have working with the community that SAGE caters to?* What is your ideal start date?* What is the frequency of the program?* One-time event Series/recurring (how many times/for how long?) Are there any special materials or physical space accommodations needed to produce the program?* In which site(s) can you offer this program? Choose as many as are applicable.* Edie Windsor SAGE Center (305 Seventh Avenue 15th Floor) SAGE Center Brooklyn at Stonewall House (271 Myrtle Ave ) SAGE Center Harlem (220 West 143rd Street ) SAGE Center Bronx (Union Community Health Center 260 E188th St., 2nd Floor) SAGE-GRIOT/Brooklyn (GRIOT Circle 25 Flatbush Avenue, 5th Floor) SAGE-Pride Center of Staten Island (Pride Center of Staten Island 25 Victory Boulevard, 3rd Floor) Please upload your resumé.* (Word or PDF only please.)