Meeting Room Application Form - Agawam Public Library

Please read Meeting Room Use Policy page prior to filling out this form. You can fill this out online, then print it out this To Be Completed Day of Meeting form and 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

:

AM/PM
Meeting will end at

:

AM/PM
Purpose of Meeting
Number Expected to Attend
Name of Organization
Mailing Address
Street Address Address Line 2 City State ZIP Code
Telephone
Fax
Email
Representative/Contact
Meeting Room Space Available (choose one)
Will you be using the kitchen? (check one)
- Yes
- No
Please Check Equipment Needed:
I have read and acknowledged the rules as set forth in Agawam Public Library's Meeting Room Policy.
Signature
Name
First Last
Date
MM slash DD slash YYYY

Date Format Should Be 00/00/0000

Multimedia Projector TV with VCR/DVD
Projection Screen
Erase-board/Chalkboard
Coffeepot