Dowagiac District Library
ROOM RESERVATION REQUEST FORM INSTRUCTIONS:
The room must be returned to its original layout.
Meeting Purpose
Meeting Date(s)
AM Number Of Attendees
Time
PM
Day (check the number of days required)
1
2
3
Name of Individual or Group Representative Signature of Representative
Contact Phone
Study Room (check the appropriate room[s])
A
B
Contact Email
Community Room
C
EQUIPMENT NEEDS Check all that apply
LCD Projector HDMI Cord Laptop Other (describe below)
____
Organizations and individuals using the Library’s meeting and study rooms are liable for any damage or soiling to furniture and fixtures (see Meeting & Study Room Policy).
____
A cleaning fee will be charged to the group representative if extra janitorial work is needed beyond regularly scheduled cleaning (see Meeting & Study Room Policy).
____
Received copy of the Meeting & Study Room Policy
initials
initials
initials
FOR REGISTRATION DESK USE ONLY Date Request Received
Date Room Confirmed
Assigned Room
Credit Card # (Community Room)
$100 Food Deposit? (Community Room)
Yes
No
Confirmation Sent?
4