Friends Room Reservation Form

Henry County Library Friends Room Reservation Form

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Name of group or organization

Press notices planned? _____

____________________________________________        __________________________________
Name of individual filing application                                              Address

_______________________________________                    ______________________________
Home Telephone Number                                                               Business Telephone Number

There is a $10.00 per day overdue charge if the Friends Room key is not returned in a timely manner.

Note: The library does not handle telephone calls or messages for Patrons

The thermostat in the Friends Room is set at the most energy efficient level and locked. An organization that wishes to change the thermostat setting may do so by paying $35.00 to cover the additional energy usage and costs involved in having the thermostat unlocked and later restored to standard settings and relocked.

I have noted the conditions for use of the room and accept the responsibility for seeing that they are complied with.

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Signature

_______________________ ________________ _________________
Date needed Hour Beginning Hour ended

Will Make Use of Kitchen ____ Yes ____ No

__________________________________ __________________________________
Non-AV Equipment needed AV equipment needed
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Fill in below if reservation is for a series of meetings:

Dates (list each below) Hour beginning Hour ending

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