APPLICATION FOR THE USE  OF THE COMMUNITY ROOM
Date of Application: 
Dates of Meetings:
Time Room Required:  Fromto
Name of Organization :
Address:
Name of Individual Filing Application:
Purpose of Meeting:

Will Kitchen be Used?yesno    Approximate Size of Group:
Chair arrangement is at the discretion of organization.  The Library does not provide audio-visual equipment, extension cords, coffee pots, etc.
                 CONDITIONS OF USE ARE GOVERNED BY ATTACHED REGULATIONS
It is hereby understood and agreed that, if this application is granted, the undersigned will assume responsibility for the payment in full before the facility is available; for the preservation of order and liability for any damage to, or loss of property that may result from  this use; and for the due observance of all regulations of the Board of Library,   Trustees.  It is also understood in case of any emergency, such as severe snow storm, when use of walks drives and parking area may not be available, it is the responsibility of the undersigned  to determine whether or not the event should be cancelled and if this is so, the Library should be notified immediately.
Signature of Officer of Organization:
Office Title:  
Address:
Telephone:

Date Application Received:  Today's Date:
 Conditions:

Fee:
Signature:Title: