Please print and complete this form, then return it to the Reference Services Desk, or mail it to Program Coordinator, Morton Grove Public Library, 6140 Lincoln Ave., Morton Grove, IL 60053.

Today's date: ____________________

Organization name: ____________________________________________________________

Date(s) desired: ________________________________

     Time: __________________ to ___________________

Expected attendance: ________________

General purpose of meeting: _____________________________________________________

Special equipment needed (projector, etc.): __________________________________________

Will you be serving refreshments? _______   If yes, briefly describe: ___________________________

As the authorized representative of the above-named organization, I hereby request use of the Library's meeting room as indicated, and have read and agree to follow the regulations stipulated in "Policy for Community Usage of Meeting Rooms" governing use of these facilities. The authorized representative must be a Morton Grove resident.

Signature: _________________________________   Phone number: ______________________

Representative's home address: ___________________________________________________________

Title/position: __________________________________________

General Rules (Consult the Meeting Room Policy for full details.)

1. All meetings shall be open to the general public, regardless of age, sex, race, religion, national origin or physical disabilities.
   

2. No admission fees may be charged. With the exception of authors, who may sell copies of their books, no money may be collected nor other money-raising activities conducted.
   

3. The library reserves the right to cancel or resechedule meetings if conflicts arise.
   

4. Rooms may be booked no more than three months in advance, and no less than 15 days in advance.
   

5. The reserving organization is responsible for leaving the facilities in order after use. All meetings must be completed by the library's normal closing time (9:00 pm Monday-Thursday, 6:00 pm Friday, 5:00 pm Saturday and Sunday)
   

6. Smoking and alcoholic beverages are not permitted on Library premises.
   

7. Groups may not exceed the stated capacity of the room.

For Staff Use Recital fee ($25) received: Amount: $_________    Date: ___________    Staff init: _____ AV operator fee received: Amount: $_________    Date: ___________    Staff init: _____