Senator Sue Serion / Many Faces of Heroin 2010-01-19 JCM
FOR fNTERN'AL USE ONLY Town of Wappinger
,-- 71ent for the Use of the 'own
Received by: Joseph P. Paoloni I,� �t� _ ����' "
Cance Robinson litles for Meetings
Date Received: / �r,
�?',.,,a 14 201 r. .
4
Serial
TOWN OF W IN
Application $100.00 Cert, of Ll TOWN CLERK
Notified Recreation (date:
Agreement for the Use of the Town Hall Facilities for Meetings
Name of Organization or Group
Marne of person repre eating the Organization or Group
Address Phone No.
This will confirm the arrangements being requested for your groups' use of the Wappinger Town Hall Facilities, as
noted below:
( } Senior Citizens Room
{ Large Meeting Room
( } Other: Specify:
The group is not expected to exceed persons
Date(s):, Time:
It should be understood that groups using the Buildings' Facilities for evening meetings must select dates when
Town Meetings are normally scheduled (i.e., Justice Court,Planning Board. etc.)Special requests will be
considered upon their 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'Wappinger 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 acti%,ities.
Arrangements 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..
N10-01.19 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 offending group, and they will not be granted
reinstatement..
I have read and understand the rules and regulations for the use of the Facilities in the To Am of Wappinger Town
Hall, and will comply with these requirements,
Signed: ,—
For: r
(Name of Group or Organization)
Date:
Approved:
Town Clerk
Date: