Montgomery County Memorial Library System

Meeting Room Application

South Regional Library

CLICK HERE TO READ THE MEETING ROOM POLICY BEFORE APPLYING

Library: ___________________________  Today’s Date: ______________________

Name of organization: __________________________________________________

Address: _____________________________________________________________

Telephone number(s): _(       )_____________________________________________

Name of representative making request: ____________________________________

Position in organization: _________________________________________________

Purpose of meeting: ____________________________________________________

Please sign an authorization to use a specific name and phone number to give to patrons who are seeking information about your organization or meeting.

Name of person patrons may contact:  ____________________________________

Signature of person patrons may contact:  _________________________________

Phone number:  ______________________________________________________

            To give all organizations an opportunity to use the meeting rooms, groups may not reserve space more than 90 days in advance or more than twice a month.

Date of meeting: ______________________________________________________

Hours: ________ to __________              Room capacity:  Small 10      Large 116

Approximate group attendance: Adults  _____________    Children  ______________

Check if you would like to use the kitchen.  ______________        (Alcohol prohibited)

Check for equipment needs:  Large Screen VCR  ______     Mobile TV/VCR  _______

Microphone  _______     Overhead Projector  _______     Slide Projector  __________

Flip Chart Easel (must provide own pad)  ____________

It is the responsibility of the organization scheduling the meeting room to confirm the date and time of the meeting with the library representative at 936-442-7727.

AGREEMENT

It is expressly understood that the library has adopted certain rules applicable to the use of the library meeting rooms. A copy of the meeting room policy will be provided. This policy shall be binding, upon such individual and the group as a whole, with the same force and effect as if written and made a part of this agreement. Furthermore, the undersigned and the group requesting use of the library facilities agree, to the extent the law allows, to hold the county harmless from and against all losses, expenses, demands, and claims made against the county arising in any manner from such group’s use of the library facilities, whether such loss, expense or demand is negligent or not. Each group using the library facility as a meeting place will be held responsible for any damage to the building or equipment used. Neither the library's address or the phone number may be used by any non-library related group as a contact or information source.

Group Name: _________________________________________________________

Signature of Representative: ______________________________________________