Request to a Use Central Library Conference Room

MILWAUKEE PUBLIC LIBRARY REQUEST TO A USE CENTRAL LIBRARY CONFERENCE ROOM

Check One: Conference Room 2A – Paul Gottfried Krikelas Technology Conference Room (Capacity: 12) Conference Room 2B (Capacity: 16)

APPLICANT AND RESPONSIBLE PARTY (MUST BE 18 YEARS OLD OR OLDER): Name:

Organization: Position in Organization: Address: City, State, Zip: Phone number: Fax number: E-mail address:

PURPOSE AND BRIEF DESCRIPTION OF MEETING:

DATE AND TIME INFORMATION (Available during Library open hours): Date(s) Entry/Exit Time Date(s) Entry/Exit Time to to

OTHER INFORMATION: Estimated Attendance (note capacities above) *Will refreshments be served? Yes No *Coffee With a Conscience is located in Central Library and offers refreshments. Visit or call 414-286-2005.

KRIKELAS CONFERENCE ROOM (2A) This section is only for applicants requesting the Krikelas Conference Room I would like to request the following equipment (available in the Krikelas Conference Room [2A] only): Television VCR DVD Player Laptop Computer LCD Projector Library Card No. (required for equipment use):

As an individual or the authorized adult representative of the eligible organization, I hereby apply to assume the responsibilities under this application. I have read the rules governing the use of these rooms and agree that these rules will be strictly observed. The applicant and/or organization agree to save and keep the Milwaukee Public Library, City of Milwaukee, harmless from any and all liability whatsoever arising out of the use of the facilities and equipment.

Date Signed

LIBRARY USE ONLY: Approved Denied. Explain:

Date: By: MPL-41E.BUS