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MEETING ROOM APPLICATION FORM

 Organization Name ______________________________________________

 Address ______________________________________________________

 Name & Title of Applicant ________________________________________

 Address ______________________________________________________

 Telephone ______________________________  Best time to call _________

 Date of meeting ____________________  Time from: ______  to: _________

 Attending _____________________________________________________

 Purpose and function of the organization (be specific) ____________________

_____________________________________________________________

_____________________________________________________________

 Nature of Meeting_______________________________________________

 I am applying for the use of the meeting in the Livonia Public Library.  I have noted the above provisions and agree to comply with them.

 Signed__________________________________ Date__________________

OFFICE USE ONLY

APPROVED:

NOT APPROVED:

FORM 10/02