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You can never get a cup of tea large enough or a book long enough to suit me.  -C.S. Lewis
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Lebanon-Laclede County Library Meeting Rooms


Name: 

Address:

City / State:

Phone#:     Email:

Date Submitted:      Date Needed:

Start Time:       End Time:

Group / Organization Name:

Purpose / Function of Organization:

Number Expected to Attend:

Room Desired:
Joan True Rm Dan True Rm Dan & Joan TrueRms
Benage Rm Andy's Storytime Rm

Responsible Person(s):

Address:

Phone#:         Email:

Person Paying for Room Rental and/or Deposit (if different than contact person):

Group / Organization Member Other Than Applicant:

Phone#:

Equipment Needed:
Podium Television VCR/DVD
Screen Projector  
 
If you want the Library staff to setup chairs, or tables and chairs, there is a $25.00 fee.
Please call 417-532-2148 ahead of time and indicate how you would like the room arranged.

Room Setup: Tables, how many?

                        Chairs, how many? 

I Would Like the Library Staff to Setup for the $25 Fee:   Yes          No
I Will Setup and Teardown the Tables and Chairs Myself With No Fee:   Yes          No

Will Food Be Provided (Fees may apply)?:   Yes     No If Yes, by Whom:
Will Event Be Open to the Public?:   Yes     No
Will Registration / Admission Charges Be Required?:   Yes     No
Is Admission Limited to Members of the Organization?:   Yes      No
Will Media Be Invited?:   Yes      No
Will Directional Signage Be Posted?:   Yes      No
Permission to Put On Public Calendar?:   Yes      No
Can the Names and Phone Numbers Listed On This Form Be Released to Library Patrons That Have
     Inquiries regarding the Meeting?:    Yes      No

I have read the policies governing the use of the Library rooms and equipment and agree to comply with them.
The Library is not responsible for accidents, damage or loss of personal items while in the reserved room.
By agreeing to this document you agree you are releasing the Library of any resposibility.

Agrees
      Disagrees       Name of Applicant

Signature (if being mailed): ______________________________________________

    

Or, print out the completed form and mail to:
Lebanon-Laclede County Library
915 S Jefferson
Lebanon, MO 65536, OR Fax to 417-532-7424,

For Staff Use Only

Application Approved By: ________________________________________

Deposit: $_____________ Date Paid:_____________________

Room Rental Fee: $__________

Equipment Fee: $__________

Total: $__________

Payment Received:______________________ Cash _____ Check _____

Received From:______________________________