|
|
Application for use of Library
Facilities
New Rochelle Public Library, 1 Library Plaza, New Rochelle, New
York 10801
Phone: 914 632-7878, Fax: 914 632-0262
Date of Application: ___________________________________________________________
Date Requested: _______________ Day of the Week: ___________________Time: _____
Name of Organization:
_________________________________________________________
Brief description of program, activity, or exhibit (include expected attendance):
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
The applicant hereby states that he/she is empowered to act for the
above-named group and
having read the regulations for the use of the New Rochelle Public Library
facilities, including
the payment of fees where applicable, agrees to abide by them.
Name __________________________________
Address ________________________________
Telephone ______________________________
On Back Please Provide Sketch Of Room Set-Up.
Approved _________________________ Not Approved ________________________
Fee Charged ______________________ Amount _____________________________
Comments _________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________