Meeting Room Application

Application for Reservation and Use of Meeting Room

Date of Application: _____________________________

Application is hereby made for the reservation and use of the LaSalle Public Library Meeting Room upon the following terms. 

Part I - Individual Information

Name of party completing this application: _____________________________

Home Address: ___________________________________________________

Residential Phone Number: _____________________________________

Part II - Group/Club/Organzation Information

Group, Club, or Organization (if applicable) _____________________________

Phone Number: ________________________________________

Name, Addresses and Phone Numbers of Officers (President, Vice President, Secretary, etc.) 

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

Part III - Meeting Information

Meeting Date Requested:  _____________________________________

Meeting Hours Requested:  ____________________________________

General Purpose of Use (Business Meeting, Panel Discussion, Lecture, etc.):

______________________________________________________________

______________________________________________________________

______________________________________________________________

Expected Attendance: ______________________________

Special Requirements, comments: ________________________________

____________________________________________________________

_____________________________________________________________

_____________________________________________________________

The Library reserves the right to cancel any reservation by giving the group at least forty-eight (48) hours notice, except in case of an emergency.  Notice of a cancellation shall be done by either telephone – 815-223-2341 or fax – 815-223-2353.

I state that the above information is true and correct.  I further state that I have received a copy of the Meeting Room Policy adopted by the Board of Trustees of the LaSalle Public Library.  I (and the above group, club or organization, if applicable), shall abide by said Meeting Room Policy and shall indemnify and hold harmless the LaSalle Public Library, Trustees and employees from any loss, cost, expense or damages occasioned by the use of the Meeting Room.

Signature of Applicant: __________________________________________

Part IV - Action of the Library

Approved/Authorized Library Representative: ___________________________

________________________________________________________________

Modification or restrictions, if any: ____________________________________

_________________________________________________________________

Disapproved/Authorized Library Representative: _________________________

_________________________________________________________________

Reason for disapproval, modifications or restrictions : _____________________

_________________________________________________________________