Application for Connections Book Discussion Series

Please complete this application four weeks prior to the date of your first Connections book discussion. If you have any questions, please contact Mary Nolin, Connections Program Manager, at

Please enter the four dates and times that your program will run.
Evaluation. We may come for a discussion on this date or join in on the 4th Connections date.
2 goals for this Connections series: what do you hope your class will specifically gain from this experience?
Assurance: By submitting this form,  I certify that the organization and individuals named in this application have agreed to participate in the proposed program on the terms specified. I understand and accept the condition that this program must be free and that NH Humanities’ support will be acknowledged verbally at the program and on ALL printed materials. I agree to complete all required evaluation and attendance forms within two weeks of the end of the program.


New Hampshire Humanities completes this section:

Payment: You will be paid one installment after you have completed two sessions and the remainder plus mileage after you have completed the series and send in your written evaluation.
Stipend:   $200 x number of sessions (2/4) + $ 50.00 Stipend if Pre-visit made.                    
Mileage: (RT from your address to the address of the program) x 4 x .50 per mile + Tolls.