Name of Group/Organization
Contact Person
Address
Telephone (xxx-xxx-xxxx)
Email
Name of President or Chairperson
Purpose of Meeting (Please describe in detail; attach agenda if available. If having a speaker, please give subject of speech.)
Meeting Date Requested Time period requested ( ___ - ___)
Anticipated Attendance
Will literature or Press releases be distributed? YesNo If so, please attach a copy.
Will refreshments be served? YesNo
If so, what type of refreshments?
Please attach any relevant documents here.
I, the undersigned, being eighteen years of age or older, have read the meeting room policy and regulations and agree to comply therewith. I agree to be responsible to the Public Library for the use and care of library property and facilities.As the undersigned, I understand my responsibilities include:
1) Paying for any damages to library property occurring during or in connection with the meeting;
2) Enforcing the meeting room regulations;
3) Cleaning up the room & leaving room in order at conclusion of the meeting;
4) Informing a library staff member that the meeting has ended;
5) Notifying the Librarian of number in attendance at meeting;
6) Returning a meeting room key (as specified by Librarian). I agree to these conditions. Please type your full name below. This is your electronic signature.
