RIDLEY TOWNSHIP PUBLIC LIBRARY

MEETING ROOM APPLICATION

NAME OF ORGANIZATION: ______________________________________________

PURPOSE OF MEETING: _________________________________________________

DATE(S) REQUESTED==INCLUDE FIRST PREFERENCE AND ALTERNATE DATE

1^ST CHOICE: ________________________________

2^ND CHOICE: _______________________________

IF THIS REQUEST IS FOR A REGULARLY SCHEDULED MEETING, PLEASE LIST EXACT DATES OF EACH MEETING FOR THE YEAR THIS REQUEST COVERS.

 DATES:   ______________________________ TIME: ________________

ANTICIPATED ATTENDANCE: __________________________

REFRESHMENTS          CIRCLE ONE:                   YES                NO

FEE         $25.00              CIRCLE ONE                   CASH         CHECK/MO

ARRANGEMENTS MADE BY:

NAME:

ADDRESS:

TELEPHONE:

PLEASE SEE THE POLICY FOR THE USE OF THE MEETING ROOM.  VIOLATION OF THESE REGULATIONS WILL RESULT IN THE CANCELLATION OF FUTURE MEETINGS.

I HAVE READ THE MEETING ROOM POLICIES AND ACCEPT THEIR PROVISIONS.

_________________                                        __________________________________

DATE OF REQUEST                                     SIGNATURE OF RESPONSIBLE PARTY

__________________                                       __________________________________

DATE OF APPROVAL                                    APPROVED

Mail form to RTPL 100 E. MacDade Blvd. Folsom, PA 19033