Meeting Room Application

Date of Meeting

Start time (including setup)

End Time

Organization Name

Date of Application

Organization address, city, state and ZIP

Organization representative

Representative address, city, state, and ZIP

Evening phone

Daytime Phone

E-Mail address

Estimated attendance

Organization's profit status
Non-Profit For-Profit 

Will refreshments be served?
Yes No 

Equipment needed
Lectern Easel TV DVD Player Screen 

Purpose of Meeting

By filling out and submitting this Meeting Room Use and Acceptance of Responsibility form, you are agreeing with and will adhere to all of the Meeting Room Policies and Guidelines.