Meeting Room Reservation Request Form

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BREVARD COUNTY LIBRARY SYSTEM
REQUEST FOR USE OF MEETING ROOM

To be filled out by party requesting reservation

Name of Organization __________________________________________________________

Purpose or Nature of Meeting ___________________________________________________

Approximate Attendance _______________________________________________________

Date/s of Program

Times: Start Time: _____ a.m. _____ p.m. End Time: _____ a.m. _____ p.m.

I agree notice of the meeting(s) will be posted by our organization and/or the library. I understand this notice shall be posted seven (7) days in advance and shall include the following statement:

According to requirements of the American Disability Act (ADA), organizations using library meeting rooms may be required to provide special accommodations for those citizens requesting assistance within 48 hours of the scheduled meeting time. Organizations are required to provide hearing devices and/or make special arrangements at the citizen's request.

I hereby affirm that I have read and understand the regulations governing the use of the library meeting room. I, as the representative of the group, accept responsibility for any damage incurred to the library or its furnishings as a result of this meeting or of negligence in securing the building, and I am responsible for this compliance.

Signature______________________________________________________________________

Please print information below:

Name_________________________________________________________________________

Address_______________________________________________________________________

Business Telephone _______________ Residence Telephone _________________

Driver's License Number__________________________________________________________

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FOR OFFICE USE ONLY

Date Received ___________________ Hour Received ________________________

Approved______________________________________________________________________

Disapproved___________________________________________________________________