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HARFORD COUNTY PUBLIC LIBRARY
MEETING ROOM RESERVATION

APPLICATION

Date ________________________

Organization _______________________________________________________

Contact Person _____________________________________________________

Address _________________________________________________________________________
________________________________________________________________________________

Daytime Phone____________________ Evening phone______________________

Type of Program: ___________________________________________________________________

Date(s) of Program_________________________________ Time(s)___________________________

Size of Group (estimated) ___________________________

Do you need enhanced listening devices?__________ Number requested __________

It is understood that all policy statements and regulations have been read and agreed upon. Inquiries about the program may be referred to the undersigned. The undersigned is responsible for all damages.

Signature of Applicant ________________________________ Date _______________________

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CONFIRMATION

Signature of Library Representative_______________________________________________

Date_______________________________________________

12/92