RUTLAND FREE LIBRARY MEETING ROOM RESERVATION FORM
Date of Program _________
Booked _____________________
Name of Organization: __________________________________________________
Room Requested:
Fox Room _________
(Capacity 173)
Title of Program: _______________________________________________________ Date(s) Requested: ________________________________ Hour(s)____ to ________ Expected Attendance: ___________ Equipment Needs Folding Tables, Large Folding Tables, Small Podium Microphone Slide Projector VCR & Monitor Opaque Projector More than 100 chairs 1 1 2 2 3 4 Chalk/Corkboard Podium Lapel Microphone Film Projector 16mm IBM PC Converter Overhead Projector Coffeepot 1 2
1
2
NOTE: Groups are responsible for set up of requested equipment including chairs, tables and coffeepots; however, the library will set p AV equipment. I, the undersigned, having read the policy and regulations governing the meeting room(s), accept the responsibilities stated therein. Applicant’s Signature____________________________________ Date_____________ Applicant’s Name (please print)_____________________________________________ Address:__________________________________ Telephone(day):________________ ___________________________________ Telephone(evening):_____________ ___________________________________ Please sign and return one copy to:
Assistant Director Rutland Free Library
10 Court Street Rutland VT 05701 (802) 773-1860 / (802) 773-1825 FAX