Each group should complete a new application once a year.

Group Name ________________________________________

Expected attendance __________

Audiovisual equipment needed ______________________________________________________

Nature of meeting or program ______________________________________________________

Purpose/function of the organization ________________________________________________________________________

________________________________________________________________________

Responsible person ______________________________________________________________

Address ______________________________________________________________________

Phone ________________________________________________________________________

Group member other than applicant ___________________________________________________

Phone ________________________________________________________________________

The names and phone number listed on this form may be released to Library patrons with inquiries concerning the meeting. ___ Yes ___ No.

I have noted the policies governing the use of the Library meeting rooms and equipment and agree to comply with them.

Applicant Signature ______________________________________________ Date ______

Application approved by __________________________________________ Date ______