Meeting Room Application

VOLUSIA COUNTY PUBLIC LIBRARY APPLICATION FOR USE OR LIBRARY MEETING ROOM At the_________________________Library

Space is requested by (official name of group)____________________________________________ The purpose of the meeting is _________________________________________________________ We are requesting the _________________Room. For (day of week)_________________________ Hours___________to______________ Date(s)

Estimated Number in Group:________________ Representative making request for Group: (Name)_______________________________________ Address _____________________,___________________________,__________________________ Phone (day)_______-_______-__________(eve)________-_________-___________________ (e-mail)______________________________________________________________________ Primary Purpose of Group: Profit:_______Non-Profit:_________Other_______________ Function of Group:__________________________________________________________________

AGREEMENT I have read and I agree to the terms of the Library Meeting Room Policy. Signature______________________________________________Date________________________ May the Library help you with your program? Please check if you will need: ___AV Materials/ Equipment (Please specify)____________________________________________ ___Book Exhibit________________________ ___Tour of Library______________________ ___Information on Library Services_______________________ ___Other__________________________

LIBRARY USE ONLY: Space available:_________________ Charge:________________________ Approved:________________Not approved:__________ Comments:_________________________________________________________________________ Head Librarian's signature_______________________________________Date________________