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ROOM USE APPLICATION
Complete this form to reserve a room at the Northampton Free Library in Nassawadox, VA or the Eastern Shore Regional Library & Heritage Center in Parksley, VA.
You can complete the Room Use request below, or if you prefer a paper copy, download the
PDF paper version
.
Please review the
Meeting Room Use Policy
.
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* Indicates required question
Application Date
*
MM
/
DD
/
YYYY
Date(s) Requested
*
Your answer
Applicant/Organization Name
*
Your answer
Applicant/Organization Address
*
Your answer
Applicant/Organization Website
Your answer
Type of Organization
*
Non-Profit
Civic/Community Group
Religious
Informal gathering of people with like-interest
Government or government related
Educational
Profit
Other:
Required
Meeting Room/Area Requested
*
E.A. Harlan McMath Literacy Center & Meeting Room [Nassawadox, VA] (8 people)
Francis B. Latimer Children's Study Room (child study room) [Parksley, VA] (3 people)
"Bea" Johnson Small Study Room [Parksley, VA] (5 people)
Large Group Meeting Room [Parksley, VA] (7 people)
Dennis R. Custis Lecture Hall [Parksley, VA] (185 people) <See Meeting Room Policy for associated fees, if applicable.>
Required
Purpose
(Please refer to #1 in Meeting Room Use Policy)
.
*
Your answer
Time reservation begins
*
Time
:
AM
PM
Time reservation ends
*
Time
:
AM
PM
Expected number of attendees
*
Your answer
Special equipment needed
*
Digital projector
Laptop
Projector screen
DVD/Video Player
Podium
Utility cart
None
Other:
Required
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