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@example.com