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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) |
__ Conf. 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 $30.00/ 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 Signature __________________________________ Date_____________
------------------------------------------------------------------------------------------------------------------------------------------------------ FOR LIBRARY USE ONLY:
ROOM USE:____ APPROVED ____ DENIED _ _LIBRARY STAFF: ________
Room Fee:: ____ Hours ($25/ hr) = $________
Custodial Fee:: ____ Hours ($30/ hr) = $________
TOTAL DUE* = $________
* Fee are to be paid prior to the function. Checks payable to: Medway Public Library.