Meeting Room Use Application

Date of application (month, date, year)

Name of organization or group

Name of person filing application

Street address or PO box   Zip

Town (mailing address)     

Daytime phone: Area Code    -

Evening phone:Area Code    -

  E-mail address (not required)

Meeting date requested (month, date, year)

AM PM Starting time          AM PM Ending Time

Expected # of attendees

Please select room:

Larison (10-100) GroupStudy (2-20)

 

AGREEMENT
I am a Chester resident and have read the "Policy for Use of the Meeting Rooms" and accept responsibility for compliance with all procedures and regulations.