Rotary Community Room A

Rotary Community Room B

Conference Room

Contact Person:

Name:

Phone:

Email:

Study Room  A

Study Room B

I, THE UNDERSIGNED, HAVE READ THE LIBRARY MEETING ROOM POLICY.  I FULLY UNDERSTAND MY RESPONSIBILITY IN USING THE LIBRARY FACILITY AND AGREE TO ALL REGULATIONS STATED IN SAID POLICY, AND DO SIGN BELOW AS MY OWN FREE ACT AND DEED.

**FOR OFFICE USE ONLY**

Room Fee (if applicable)

Paid

Not paid

Deposit  PD

Deposit  not PD

Room use report:

_____Satisfactory        _____Unsatisfactory / Reason  (Detail damage or items missing on the back of this sheet)

Revised 9/08