EmailMe Form - Tecumseh Meeting Room Application Form

Date of Event

MM / DD / YYYY

Setup Start Time

HH : MM AM/PM

Setup End Time

HH : MM AM/PM

Actual Event Start Time

HH : MM AM/PM

Actual Event End Time

HH : MM AM/PM

Approximate number of attendees

Available Facilities (select one)

For Profit

Non-Profit

Do you need to use the projector?

For Profit

Non-Profit

Please read and check ALL of the points below

I understand how to use the technology in the room.

I understand there is no one on staff to assist with the technology.

I understand I am responsible for the condition of the room.

I understand that all tables and chairs have to be put away and that everybody needs to leave the room 15 minutes prior to closing time.

I received and read a copy of the Use of the Meeting Room Guidelines.

Purpose of use

Name of organization

Name of person responsible

Address

Email

Phone

### - ### - ####

Is your organization for-profit, or non-profit?

For Profit

Non-Profit