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Dutchess County Executives Office Nov, 25, 2015 1 : 44PN1 No, 234$ P. 1 2010-01-19 JCM FOR INTERNAL USE ONLY Town of Wappinger Received by: Joseph P. Paoloni ❑ Agreement for the Use of the Town Grace Robinson Hall Facilities for Meetings Date Received: L E serial#: Q Application ❑ $100.00 ❑ Gert. of LI r ❑ Notified Recreation(date:_ Agreement for the Use of the 'down Rall Facilities for Meetings Nairn of Organization or Group Name of person representing the Organization or Grl-�up Address Phone No, This will confirm the arrangements being requested for your groups'use of the,Wappinger Town Hall Facilities, as noted below.- Senior elow:,Senior Citizens Room ( ) Large Meeting Room Other: Specify: A7 P.., j 1 The group is not expected to exceed persons _ Time: Itshould be Understood that groups using the Buildings' Facilities for evening meetings must select dates when Town Meetings are iioTmally scheduled.(i,e-, Justice Court, Planning Board,etc.) Special requests will be considered upon thein own merit, and arrangements can be made for access to, and closing, the building at the close of your meeting. You and your Organization hereby agree to adhere to the rules set forth on the attached page by signature of an authorized member of your Organization or group. The Town of Wappingor reserves the right to suspend temporarily this agreement should the Town have need of the facility for its own purposes. Advance notice will be given as soon as possible on such occasions. The Town [clerk should be informed promptly of any schedule change or cancellation of your group activities. An.-angements for access to specific area to be used should be made with the Town Clerk at the time this form is submitted. No application shall be considered approved until it has been submitted to the Town Clerk for review and Clearance. Nov, 25, 201 a 1 ; 44PM Na, 2348 P. 2 2010-01-19 JCM Terms of the agreement must be strictly adhered to by the contracting group as any disregard or abuse of the rules for use of the facilities will result in termination of use by the offeridirig group,and they will not be granted reinstatement, I have:read and undorstand the rules and regulations for the use of the Facilities in the Town of Wappinger Town Hall, and will comply with these requirements. Signed: For: Name of Group or Organization) Date: D'� Ifs Approved: Town Clerk Date: