Date and Time

Date(s) room wanted

Time
from to

Organizational Information

Name of Organization

Person applying

Position in group

Address

Business telephone

Home telephone

E-mail address

President of group (if applicable)

President's Address

President's Telephone

Meeting Information

Meeting purpose/type

Expected attendance (100 person maximum)

Will refreshments be served? (group responsible for clean up)
Yes No

Equipment

Equipment needed
TV/VCR/DVD
Easel
LCD projector
Podium
Overhead projector

Number of tables

Number of chairs

Any special requirements or requests?

By clicking "Submit Request," I affirm that the Meeting Room Policy is understood, will be adhered to, and that the guidelines for use will be conveyed to the membership/attendees.

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