Meeting Room Policy - Helen Matthes Library

Application for Use of Luttrell Room
Date of Meeting _______________________________
Meeting Time: From____________ To ____________
Setup: none 15 mins. 30 mins. 60 mins.
(please circle)
Cleanup: none 15 mins. 30 mins. 60 mins.
(please circle)
For Staff Use:
Date scheduled: ______________ Initials: ________
_____ Non-Profit Groups Scheduling 1 month in advance
and Businesses = $10/hour charge
Name of Group ____________________________________________________________________________________
Contact Person ___________________________________________________________________________________
Mailing Address ___________________________________________________________________________________
Telephone: Business _________________________________
Type of Activity ______________________________________
(discussion, film, organizational, etc.)
Cell ________________________________________
Expected Attendance ____________
Will food be served? No Yes Key needed? No Yes If yes: Key # ______ Date picked up: ______
(please circle)
Key # ______ Date returned: ______
Phone number to offer public in case of questions: ________________________________
I have read and understand the rules for meeting room use. I also declare that I/the organization agree to return the
library facilities used to a clean and orderly condition at the end of the activity and to pay the cost for repair of any damage to
the library property incurred in connection with this meeting.
Signature of Applicant _________________________________ Date ______________
Staff initials that photo ID was checked _______ Staff initials that filled out form _______
For groups with multiple dates over the course of a season:
Ex: _______________________
mm/dd Initials pd?
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