SAGE NY Programming Proposal Form

First Name

Last Name

Phone Number

Organization Name (if applicable)

Address

Apt.

City

Borough

State

Postal Code

Please briefly describe the program you propose leading at SAGE

Are you interested in providing this program on a voluntary basis?

YesNo

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 LGBTQ+ elders. What experience, if any, do you have working with the community that SAGE caters to?*

When is your ideal start date?

What is the frequency of the program?

One-time eventSeries/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, NYC)SAGE Center Brooklyn at Stonewall House (271 Myrtle Ave, Brooklyn)SAGE Center Harlem (220 West 143rd Street, Harlem)SAGE Center Bronx at Crotona Pride House (1784 Prospect Ave., Bronx)SAGE-Pride Center of Staten Island (Pride Center of Staten Island 66 Willow Avenue, Suite 202, Staten Island)

Please upload your resumé. (Word or PDF only please.)

Contact Information