Fillable Meeting Room Request Form.020915 Meeting Room Request Form

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Meeting Room Request Form.020915 Meeting Room Request Form

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The Meeting Room Request Form.020915 Meeting Room Request Form form is 1 page long and contains:

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  • 18 check-boxes
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01/15
HOMER CITY HALL 491 E. PIONEER AVE.,HOMER, AK 99603
www.cityofhomer-ak.gov/city clerk
907-235-3130
MEETING ROOM REQUEST FORM
Meetings are subject to approval by the City Clerk's Office. You should not advertise your meeting or
assume your request has been approved until you receive confirmation from staff.
Meeting Information
Name of Organization
Person Responsible During the Meeting
Mailing Address
Email
Phone
Subject or Purpose of the Meeting
City Hall Cowles Council Chambers (accommodates up to 37 people)
$30 per hour with a 2 hour minimum, maximum fee of $150 per day
Initial here
City Hall Conference Room (accommodates up to 15 people)
$15 per hour with a 2 hour minimum, maximum fee of $75 per day
Initial here
Cleaning Fee
If the Facility is not left as found, an additional fee of up to $60 may be applied.
Initial here
Requested date(s)
Start Time
End Time
(include set-up)
Equipment Needs
Communication/Media
$30 Set up Charge
Initial here
must be out of room by this time
Communication/Media Equipment Needed
Teleconference Capability
Wireless Internet Connection
TV & City Hall Computer
Video Conference (Skype, GoToMeeting, etc.
Audio
Audio Recording
TV & Connection to Personal Computer
Apple
PC
HDMI Connector
Yes
No
OTHER
Tables
Tea Kettle/Coffee Pot
Flip Chart
1
I understand that the above listed fees apply for room rental, media set up, and cleaning. I also understand that if the
meeting is after regular business hours I will check out a key from the City Clerk's Office the day of the meeting no later
than 4:45 p.m.
Signature
Date
Submit this form to the Clerk's Office, fax to 907-235-3143 or email clerk@ci.homer.ak.us
TENTATIVE
ON CAL
APPROVED
CONFIRMED
ON CALENDAR
ATTENDANCE ?
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Meeting Room Request Form.020915 Meeting Room Request Form

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Completed 11 July 2020

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