“meeting rooms are generously provided by the taxpayers of Chisago County

Chisago County Library Meeting Rooms

An East Central Regional Library

Request For Use

Request

Date

 

Time of

Use

 

Today's

Date

 

Name

 

 

Street

Address

 

City,

State, Zip

 

Phone

 

 

Cell

Phone

 

Fax

 

 

Drivers License Photocopied Yes No

 

Text Box: State purpose and organization:I am requesting to use the Chisago County Library Meeting room for:

I agree to respect the facility. I understand that I am responsible for the behavior of the room occupants. I also understand and agree that I will be personally responsible for any and all facility damage, equipment damage and clean up. I will be responsible to ensure that the maximum room occupancy limit is honored.

 

_____________________________________________________________________

Signature Date

 

Librarian

 

Request Granted

 

Request Denied

 

Request date changed to______________________

 

Signed __________________________________________________ Date__________________