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Churchville Branch Library Meeting Room Application
Email address *
Name of Organization *
Your answer
Date of Meeting *
MM
/
DD
/
YYYY
Time of Meeting *
Time
:
Nature of Meeting *
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Estimated Number Expected *
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Please list the names, addresses, and phone numbers of up to two adult leaders who will be in attendance the full time of the meeting. *
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President or Leader of your organization *
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Your name and position within organization *
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Your Address *
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Your phone number *
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Representative's signature (By typing your name below and submitting this form, you agree to abide by our meeting room policies.) *
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