Meeting Room Application Form
Please read Meeting Room Use Policy page prior to filling out this form. You can fill this out online, then print it out and mail it or bring it to the library.
Permission is hereby requested for use of one the meeting rooms. The person signing this request has read the Meeting Room Policy and pledges the cooperation of his/her organization.
Day & Date of Meeting
Meeting will begin at
Meeting will end at
Purpose of Meeting
Number Expected to Attend
Name of Organization
Mailing Address
Telephone Fax
Representative/Contact
Meeting Room Space Available (circle one)
Community Room Seating Capacity=150 Conference Room Seating Capacity=20
Will you be using the kitchen? (check one)
Yes No
Please Check Equipment Needed:
Multimedia Projector TV with VCR/DVD
Projection Screen
Erase-board/Chalkboard
Coffeepot
I have read and acknowledged the rules as set forth in Agawam Public Library's Meeting Room Policy.
Signature of Applicant
Name (please print or type)
Date
Approved by
Date
To Be Completed Day of Meeting:
Condition of Room(s)
I have walked through the room(s) with the supervising librarian and agree to the condition of the room(s) listed above.
Signature of Applicant
Name (please print)
Signature of Supervising Librarian
Date
(Application Form Last Updated 6/09)
