Room Use Application for Commercial Use of Library Meeting Rooms
PLEASE COMPLETE THIS FORM.  ONCE SUBMITTED, THE LIBRARY DIRECTOR WILL CHECK FOR AVAILABILITY OF THE SPACE ON THE DATE YOU REQUESTED AND WILL CONFIRM WITH YOU VIA EMAIL.  UNTIL THEN, YOUR REQUEST IS NOT CONFIRMED.
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Number of Hours *
Rate *
Equipment Needed *
Required
Total number of people *
Method of Payment *
Sponsoring Organization *
Billing Address *
Contact Person *
Telephone *
Email *
Note: Due to prohibitive costs, the library does not permit room rental outside of normal library hours. Additional hourly fee will be charged if premises are not evacuated in a timely manner.
Date of Event *
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Start Time *
Time
:
End Time *
Time
:
Purpose of Gathering *
Choose Location *
Requested Room Set Up *
Based on your use of the room, it has been determined that you will provide the library with a certificate of public liability insurance in the minimum limits of $100,000 each person, $300,000 each occurrence Bodily Injury, and $100,000 each occurrence Property Damage with the John C. Hart Memorial Library and the Town of Yorktown specifically named as Additional Insured. *
Required
The foregoing application is made in accordance with the statement of policy and the rules and regulations of the John C. Hart Memorial Library. The undersigned has read and accepts responsibility for compliance with this policy and regulations. *
Required
Full Name *
Date of Application *
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