City of Temple Terrace Customer Service

2. Application for Use of Meeting Room and Robbins Room
4. Date
   Date
5. Library Card Number
7. Official Name of Group:
9. What is the primary purpose of your group?
11. Date and Time
    Date and Time

    Date and Time
12. Expected length of program
14. Expected Attendance
16. Requested room

    1. Large Meeting Room (50 people maximum capacity)
    2. Robbins Conference Room (12 people maximum capacity)
18. Will you be submitting an addendum form and $25 fee to request use of food and beverage in the large meeting room? (Note: Request not finalized until application is approved and fee is paid with cash or money order. The addendum is for the large meeting room only. No food may be taken into the conference room.)

    1. Yes
    2. No
20. Representative Completing Application (adults only)
22. First Name
23. Last Name
25. Office Held
27. Address
29. City
30. State
31. Zip
33. Telephone
34. Email
36. I, as an officer of the group, accept responsibility for any damage to the Library as a result of this meeting. Any damage caused during the meeting will be charged to the cardholder’s account listed above. By signing below, I am attesting that I have read the Meeting Room Policies, I agree to abide by all regulations stated therein and that my organization does not unlawfully discriminate in its membership policies.
37. Signature
39. At the conclusion of your meeting, PLEASE PROVIDE THE LIBRARY WITH THE NUMBER OF PEOPLE WHO ATTENDED.
41. *An additional form is provided in order to include food and/or beverages in your meeting.
Leave This Blank:


42. Print Only

* indicates a required field