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2. Application Date
   Application Date
6. Organization Name*
8. Presiding Officer
9. Office Phone Number*
10. Home Phone Number*
12. Contact Person*
14. Address*
16. City*
17. State*
18. Zip Code*
22. Purpose of Meeting*
24. Date(s) / Time(s) of Meeting*
    Date(s) / Time(s) of Meeting

    Date(s) / Time(s) of Meeting
25. Expected Attendance*
27. Number of Chairs
28. Number of Tables
30. Refreshments?

    1. Yes
    2. No

32. I have read the Meeting Room Use Policy (PDF) and will inform our membership of their responsibilities for using the Meeting Room of the Ingleside Public Library. I accept responsibility for leaving the room in good order or any damages that may occur to the facility or equipment resulting from our use and agree to pay the cost of repair or replacement. The Ingleside Public Library will not be responsible for damage or loss of materials used or left in the building.

34. Date
    Date
35. Representative
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field