Program Room Request Form
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Nonprofit Organization Name: *
Applicant Name and Position: *
Contact email: *
Contact phone number: *
Room request date: *
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Day of room request: *
START Time (Please refer to our open hours when making your request; all meetings must end one half hour before closing time.): *
END Time (Please refer to our open hours when making your request; all meetings must end one half hour before closing time.): *
Is your organization a non-profit and/or 501c3? *
Is your meeting free and open to the general public?  *
Description of meeting (please be as detailed as possible: include organization's nonprofit status, website, etc.): *
List any Special Requirements or AV Equipment requests (please be specific and provide details): *
Description of room setup (NOTE: Applicant is responsible for setup and breakdown of room): *
Expected Attendance (max capacity 80): *
PLEASE READ THE BELOW GUIDELINES FOR PROGRAM ROOM USE:
- No custodial services are provided in connection with use of the meeting rooms. All trash, food, and meeting-related items must be removed by the group at the end of the meeting, and the room shall be left in a clean and orderly condition. 

- Applicant is responsible for setup and breakdown of tables and chairs. 

- Please review the library's Program Room Use Policy prior to submitting your request.

I understand and accept these room use guidelines, have read the Program Room Use Policy, and take responsibility for ensuring all participants are aware of and will follow these guidelines: *
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