Meeting Room request

When is your meeting? Please enter your desired date or multiple dates separated by a comma (,) *

What time is your meeting? Please include BOTH start time and end time. Note: Room must be vacated 15 minutes prior to Library closing. *

What is your name? What is your Organization"s Name? *

Purpose of Meeting *

Contact Person / Title *

Contact Phone *

Contact Email *

Complete Address : including Street, Town, State and Zip Code *

What type of Library Equipment will you be using? Please have your Library card with you to borrow our equipment *

I have read the Middletown Public Library Meeting Room Use Policy and agree that my organization will abide by this policy with regard to the use of the Meeting Room - SIGNATURE REQUIRED, PLEASE SIGN BELOW *

Submitted Date *