Fredonia Public Library Lafferty Community Room Use Agreement
Name of Group or Individual *
Your answer
Contact Person *
Your answer
Address *
Your answer
Phone *
Your answer
Email *
Your answer
Purpose *
Your answer
We/I would like to use the Community Room on (Date): *
MM
/
DD
/
YYYY
From (Beginning Time): *
Allow yourself time to set up the room.
Time
:
Until (Ending Time) *
Give yourself plenty of time to cleanup.
Time
:
Media Rentals: *
Please check any of the following if you will need them. Each Media Rental asks a $5.00 donation paid in advance.
Required
Responsibilities: *
Please check that you understand the following.
Required
I have read the Rex Lafferty Community Room Use Policy and agree to abide by it. *
Please provide your name as an electronic signature and date.
Your answer
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