Farmington Public Library
Meeng Room Applicaon Form
Applicaon approved by: Date:
Amount paid:Deposit/Rental Fee paid
Date of meeng: Time of meeng: to
Name of group/organizaon:
Name of responsible party (please print):
Address:
Phone:
Email address:
tables and chairs (seats 48)
projector other (please specify)microphone
chairs only (seats 100) other (please explain below)
For Sarah Barton Murphy Community Room applicants only:
Please indicate how you would like the room set up:
Purpose or funcon of the organizaon (please be specific):
Room being applied for: # attending:
Signature of applicant: Date:
Is this group/organizaon a non-profit? Yes No
Yes NoWill refreshments be served?
Yes NoWill library equipment be needed? (use is subject to approval
Check here to indicate that you have read and agree to the Farmington Public Library Meeting Room
Policy located at http://farmington-mo.gov/library/meeting-rooms/. I understand that compleng this
form does not guarantee the use of a meeng room for the requested date and me.
click to sign
signature
click to edit