Date of Application _________________________

FOR____COMMUNITY ROOM (Seats 70 Capacity 145) Non-profit $25/hr.; For profit/private events $100/hr.

Name of Organization:

Contact Person or Person Responsible:                                                                                                                      Phone #

Address                                       E-mail                                                                                                                           Cell Phone #

Brief description of Program

Date of Program                              Program will begin at:                                                                                         Program will end at:

Size of Group expected                   Adults                                                                                                                    Children

# of Tables and Chairs Requested: Items presently available are 8 tables and 70 chairs

Refreshments will be served: Yes_______________ No _______________
(Refundable $50 deposit required if food will be served)

Total Fees Due: _____________ Amount Paid: _____________Date Paid: _______

Use of the Community Room by any organization outside regular Library hours will require a payment of $50.00 per hour to reimburse the Library for staff time, in addition to any other applicable fees.

Please contact the Linda in the Business Office with any questions at (914) 630-5890 or email [email protected]. All applications to use the Community Room is subject to approval by the Library Director.

The library provides free access to a DVD/video player and projection system. Patrons must provide their own laptop computers and have a trial run prior to the program to ensure compatibility with the audio-visual equipment.

The undersigned has read the meeting room policy and accepts responsibility for compliance with the policy.

Signature: ________________________ Approved: ___________________________ Jennifer O’ Neill, Library Director