Program Room Request Form
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Organization Name: *
Applicant Name and Position: *
Contact email: *
Contact phone number: *
Date of room request: *
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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.): *
Any Special Requirements or AV Equipment needed? (please be specific): *
Description of room setup (Note: parties are responsible for both setup and breakdown of any furniture used): *
Expected Attendance (max capacity 80): *
GUIDELINES FOR PROGRAM ROOM USE:
- Masks are encouraged: an inherent risk of exposure to COVID-19 exists in any public place where people are present.

- Parties are responsible for complete setup and breakdown of tables and chairs

I understand and accept these room use guidelines, and take responsibility for ensuring all participants are aware of and will follow these guidelines: *
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