Note: This form is being updated and is not ready for use just yet. Please check back in a few days. Thank you.

Queen Anne's and Talbot County Free Libraries

Community Information Database
Data Collection Form

Please fill out this form carefully and as completely as possible. If a question doesn't apply to your organization, just leave it blank. We appreciate your efforts to inform the community about your organization.

Official Name:
Alternate Name:
Physical Address
Street:
City:
State:
Zip:
Mailing Address (if different)
Street:
City:
State:
Zip:
Contact Person
Name:
Title:
Phone:
Toll free phone:
Fax:
TTD or TTY:
Email:
Web Page Address:
Hours of Operation:
Membership Meetings (frequency, time, location, etc.):
Geographic Area Served (name of town(s) or county(s)):
Descripton (services, activities, etc.):
Programs:
Special Events:
Target Group (for whom your services or activities are intended):
Eligibility
Requirements (age, income, etc.):
Fees/Dues:
Admission Procedures:
Meeting Rooms(s)
Available to:
Name of facility:
Description of facility:
Maxinum number of people:
Accomodations For the Disabled:
Yes No Some
Equipment to Loan
Type of Equipment:
Description:
Rental Fee:
Available To:
Travel (directions, parking, etc.):
Publications (title(s), frequency of publication, cost, etc.):
Volunteers Needed:
Yes No
If Yes, Skills Needed:
Volunteers Provided:
Yes No
If Yes, Requirements:
Expiration Date (month and year in which we should contact you for changes):
Additional Information (anything we forgot to ask about):

Questions:

Contact:

Chris Eareckson
410 822 1626
chrise@talb.lib.md.us

Scotti Oliver
410 822 1626
soliver@talb.lib.md.us

Thank You!