Meeting Room Request

Ridley Township Public Library Meeting Room Application

Name of Organization: ______________________________________________

Purpose of Meeting: _________________________________________________

Date(s) requested – include first preference and alternate date

1st choice: ________________________________

2nd choice: _______________________________

If this request is for a regularly scheduled meeting, please list exact dates of each meeting for the year this request covers.

Dates: ______________________________ Time: ________________

Anticipated Attendance: ______________________

Refreshments    circle one:     yes     no

Fee     $25.00    circle one   cash   check/M.O.

Arrangements made by:




Please see the policy for the use of the meeting room.  Violation of these regulations will result in the cancellation of future meetings.

I have read the meeting room policies and accept their provisions.

_________________                                        __________________________________
Date of Request                                       Signature of Responsible Party

__________________                                       __________________________________
Date of Approval                                            Approved

Mail form to RTPL 100 E. Macdade Blvd. Folsom, PA 19033 or email as an attachment to [email protected]