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MEDWAY PUBLIC LIBRARY 26 High Street, Medway MA 02053 MEETING ROOM USE APPLICATION |
NAME OF ORGANIZATION:_________________________________________________________
PERSON FILING APPLICATION:_____________________________________________________
ADDRESS: _________________________________________ PH: ______________
ROOM REQUESTED:
| Cole A (Up to 25) |
Cole B (Up to 50) |
Cole A+B (Up to 100) |
Conference Rm (Up to 12) |
Story Rm (Limited use) |
DATE(s) REQUESTED: ______________________________________________________
TIME: _________ to _________ GROUP SIZE: _________ FEE:_______________
Fee: We will pay the $25 fee assessed to "for profit" groups, organizations or companies.
Waive fee: Our organization is funded primarily by donations, fund-raising or member dues.
PLEASE READ THE FOLLOWING AND SIGN BELOW
I have read and understand the attached regulations governing the use of meeting rooms, and agree to comply with these regulations. I understand there will be an additional $15.00/ hour "custodial fee" if special permission has been granted to use library facilities beyond regularly staffed hours. This application is subject to library director's approval.
Applicant/ Authorized Signature ___________________________________ Date:_____________
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LIBRARY LIBRARY USE ONLY:
ROOM AVAILABLE: _________________ APPROVED: _______ DENIED: _______
LIBRARY APPROVAL: _____________________________ DATE (s):____________
FEES ----------- ____$25.00 ____ No Fee (for each of _____ dates) = $________
Custodial FEE: ____ Hours ($15.00/ hour) = $________
(Payable by commencement of meeting) TOTAL DUE: $________
Make checks payable to: Medway Public Library