BENSON MEMORIAL LIBRARY MEETING ROOM SCHEDULING FORM

Name of organization/business: _________________________________________________________________________

Desired date and time of meeting: ______________________________________________________________________

Purpose or nature of meeting: ___________________________________________________________________________

Desired Room (check one):    ☐ Board Room (10-15 people)      ☐ Community Room (up to 50 people)

Person in charge  

Name: ____________________________________________________________

Address: __________________________________________________________

Phone:  ___________________________________________________________

 If any question below is answered “yes,” then the organization must pay the $25.00 rental fee.

• Will there be any buying or selling of goods or services involved?   ☐ Yes   ☐ No
• Will the meeting be used for sales promotion?   ☐ Yes   ☐ No
• Are any fees charged to meeting participants?   ☐ Yes   ☐ No

Is the organization/business a member of the Titusville Area Chamber of Commerce?  ☐ Yes   ☐ No

Expected # in attendance: ___________________

Date request submitted:  ____________________

Meeting Room requests can be emailed to jessica.hilburn@ccfls.org or mailed to the library at the address below. If a group has to pay the rental fee, please send a check made to BENSON MEMORIAL LIBRARY via mail to:

Benson Memorial Library

℅ Jessica Hilburn

213 N. Franklin Street

Titusville, PA 16354