YOU MUST FILL OUT ONE OF THESE FORMS EVERY TIME YOU WISH TO RESERVE THE MEETING ROOM. No reservation can be confirmed until this for is completely filled out, signed, and returned to the library. RESERVATIONS CANNOT BE MADE OVER THE TELEPHONE. To be assured of receiving the desired date and time, please complete and submit this form as early as possible--at least one week in advance. Before you sign or fill out this form, read the MEETING ROOM POLICY & RULES, then sign below.

I have read and I understand the library's policy and rules concerning the use of the library's meeting room. I agree to use the facility according to the policy and rules.

Signed,_______________________________

TODAY'S DATE _____________________________________________________________

DATE YOU WISH TO RESERVE THE MEETING ROOM _____________________________

TIME YOU WISH TO RESERVE THE MEETING ROOM ______________________________

NAME OF GROUP ___________________________________________________________

YOUR NAME & POSITION IN GROUP____________________________________________________________________

YOUR MAILING ADDRESS____________________________________________________

YOUR TELEPHONE NUMBER: Home ____________________ Work _________________

NAME OF PRESIDENT/CHAIRPERSON: ________________________________________

TYPE OF ACTIVITY TO TAKE PLACE IN MEETING ROOM--Please circle all
that apply:

Speaker
Exhibit
Film
Panel discussion
Organization Meeting

Other (please describe): _____________________________________________________

TOPIC OF MEETING ________________________________________________________

WILL REFRESHMENTS BE SERVED? ________

EXPECTED ATTENDANCE ________________NOTE: Please report actual attendance to the Circulation Desk after your meeting is completed.

If you need any library-owned equipment for your meeting, please list it below. When you use library equipment, you are responsible for any damage to materials or equipment.

Equipment needed: ________________________________________________________

Please attach a copy of any literature, materials or press release to be distributed


_________________________________________________________________________
FOR LIBRARY USE ONLY

Approved ________ Notified _________ Initials ________ Actual Attendance _________

You may submit this form by fax (910) 862-8777 or bring to library.