Topsfield Town Library Meeting Room Reservation

1 South Common Street Topsfield, MA 01983
978-887-1528    FAX: 978-887-0185   mto@mvlc.org
Date of Application:

Name of Organization: ________________________________________________________________

Person responsible for program: ________________________________________________________

Address: _____________________________________________________________________________

Telephone/ Cell Phone:________________________________________________________________

Email: _______________________________________________________________________________

Meeting Date Requested:__________________________Alternative Date:_____________________

Starting Time: _________________ Ending Time:_________________, time for set-up_________

Title, Subject and Purpose of Meeting: __________________________________________________

_____________________________________________________________________________________

______________________________________________ Estimated Attendance: __________________

Equipment Needed: ____________________________________________________________________

______________________________________________________________________________________

How does this group serve the Topsfield area?____________________________________________

______________________________________________________________________________________

I have read the Topsfield Town Library Meeting Room Policies and Procedures and I agree to abide
by them. I understand I am responsible for the proper care of the room.


Signature___________________________________________ Date______________________

Office Use Only

Approval Signature__________________________________Date_____________________