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2. Applicant Name*
3. Applicant Telephone*
4. Email Address*
6. Title of Event*
7. Meeting Date Requested*
   Meeting Date Requested

   after July 1, 2025

8. Time Period Requested*
   Time Period Requested Start Time

   —

   Time Period Requested End Time
10. 1. Check if Applicant is NOT the designated Contact Person.
12. Contact Person
13. Contact Telephone
14. Contact Email Address
18. Name of Group/Organization*
19. Name of President or Chairperson
21. Organization Physical Address*
23. City*
24. State*
25. Zip Code*
29. Purpose of Meeting*

    Please describe in detail; attach agenda if available. If having a speaker, please give subject of speech.

30. Anticipated Number in Attendance*
32. Is the meeting or event open to the public?*
    -- Select One --YesNo
33. Will Literature or Press Releases be distributed?*
    -- Select One --YesNo

    If so, please attach a copy.

35. Please attach any relevant documents here.
39. Acknowledgment

    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).
41. Agreement*

    1. I Agree to these conditions
42. Agreeing Party*

    Please type your full name. This is your electronic signature.

Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit

* indicates a required field