DATE REC'D:_________________

 

APPLICATION FOR ACCESS AND USE OF CML Children’s Activity Room

The Children’s Activity Room of the Clapp Memorial Library is, on occasion, available for use by established

Belchertown non-profit and community groups, when not being used by the Library, and is only available

during regular Library hours. The complicated nature of Library programming and scheduling , however,

results in very limited openings. Library use always overrides other requests. The room may not be reserved

more than two months in advance.

 

Name of Organization: __________________________________________


 

Contact Person: ________________________________________________________________


 

Address _________________________________________________


 

Telephone No. DAY _____________________ EVENING_____________________


 

E-Mail: _______________________________________________________________________


 

Briefly describe the nature of your program.: _______________________________

_________________________________________________________________________

_________________________________________________________________________

___________________________________________________________________________

Is this a non-profit organization?_________________________________________


 

This program would take place: Date _____________________________________


 

Beginning Time_______________________ Ending time _______________________


 

Estimated Attendance ______________


 

I understand that it is my responsibility to return the room to the condition and arrangement in which it was found.


 

________________________ _______________________

Signature/ Title Date


 

_______________________ _______________________

CML Approval Date


 

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