Cheatham County Public Lindahl Room Request Form:
| Name of Organization |
|
| Address |
|
| City |
|
| State |
|
| Zip |
|
| Telephone |
|
| Fax |
|
| Email |
|
| Contact Person |
|
Organization is
___not-for profit
___for–profit (See Fee Schedule) |
| Dates and Times requested |
|
| If this is a request for a standing
booking, supply all dates requested and the time of day that your
organization meets: |
|
| Describe the purpose of this meeting: |
|
| Approximately how many people will attend
your meeting? |
|
| Will your organization need to use any of
the following: |
|
| - Library's audiovisual
equipment? |
___Yes
___No
|
| - Kitchen? |
___Yes
___No
|
| Will your organization need
to use any of the Library’s audio-visual equipment?
___Yes
___No |
|
Your group has
access to the community room equipment and the kitchen only. There
will be a replacement charge for lost key. |
I as the representative of the organization requesting the library’s
meeting room, I have read the Meeting Room Policy and Procedures and
signed the attached statement. Further, I have made arrangements for the
prompt payment of any required fees connected with the organization’s use
of the facilities. I understand the charges for damages to the facility,
furnishings or equipment will be billed to the organization.
| Responsible Person: |
|
| Group Name: |
|
| Signature: |
|
| Date: |
|
|
