Online Meeting Room Application

Name of organization*

Address of organization

Website or blog (if available)

Mission Statement

Individual responsible for room reservation*

Individual(s) present on day of event

Telephone number*

Email Address*

Format of event*

Estimated attendance*

Intended audience

Requested date(s) and time:*

Please include start and end time.

Describe event in a few sentences.*

Room arrangement preferred*

Theater style
Chairs around a table
Chairs in a circle

For listing on the Wayland Library Event Calendar:

Title of event*

Time of Program Start: ________ End: _________*

Contact person?*

Please include Phone or email

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Comments:

Right of refusal*

Accept

I am aware that the library will deny this space to any group or individual that discriminates on the basis of a person’s membership in a protected class, including race, national origin, religion, disability, age, sexual orientation, or gender identity.

I have read The Library's "Use of the Raytheon Room" Policy Statement and agree to abide by the guidelines established by the Board of Library Trustees.*

I agree to the terms.
I do not agree to the terms.

Below this line for office use only

Director's Signature

Date

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What can we help you find?

Meeting Room Application

For listing on the Wayland Library Event Calendar:

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