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Dutchess County Board of Elections@6f @6f 2@12 11: @1 8454862483 FOR ]NTER111AL_USE ONLY Received by: Cl~risti;ae Fulton 3e ~sica Fulton. C7 Date Received; ~ 1(~ /~l ~' Serial #: ~,~_ ~l Application ^ !;140.00 ^ Cert. of LI ^ XVotired Recreati.o:o. (date:~_} PAGE @2f @3 2010-01-19 JCM Towxx of Wappizalgex Agreement ~~~ the Use of the Town ~a11 Facilities for Meetings Ag reexneaat for the ~ Tse off' the Town Hall. Faci~it~es far 1Vleetiings ~-~-~C YES Name of Organization or Group ~~~~ ~ ~~~ Name afpcrson repres~~ntirxg tkte Organizati ~n or Group Address Fhone No. This will con,~Txn the arrangements beia;tg re tuested for your groups' use of the Wappinger Town Hail Faci.Iities, as n otcd below: {) Senior Citizens Room Large Meeting :~.aom () Other: Specify: ~~a~:~-r h ~.. The group is Hat expe~t~.d to exceed „_persons ~ ~+ ~ ,l I '. I Ca ~ O b Pit Date(s):' Z3 ~ I s ~!' + i"'~ vd: Time: GElec fin ~r'~ jtil Gc~y~ Spn~~- It should be understood that groups using the : buildings' Facilities for evening meetings zuust select dates when Town Meetings are normally scheduled (i.e. Justice Court, Planning Board, etc.) Special requests will be considered. upon their otivaa. merit, and. axrang ~.ents can be made for access to, and closing, tie building at the close ofyour meeti,rag. You and. your Organization hereby agree to ; .dhere to the rules set forth on the attached page by signature of an authorized member of,~aur Organization or ~ soup. The Town of Wappinger reserves the right tt suspend temporarily this agreement should the Towt1 have need of the facility for its own purposes. Advance Horace will be given as soon as possible on such occasions. The Town Clerk should be informed prompt; y of any schedule change or cancellation of your group activities. Arrangements for accts.; to speci:fc area to b ~ vsed should be axzade vs+~ith the Town Clerk at the time this farm is submiitecL No appii.cation shall be ~ronsidered approved ~util it has been submitted to the Town Clcxk for review and Clearance. 06f06f2012 11:01 8454862483 PAGE 03f03 2p 1001-1 ~ JCM Terxx~s of the agxeeme~xt must be strictly ad tired to by the contracting group as any disregard or abuse of the axles for use of the facilities wi11 result in termizt, ~~ion of use by the offending group, and they will ztot be granted reinstatement. I have seed and u~t.derstand the axles and rel;ulations for tUe use of the Facilities in the Town of Wappinger Towa~ Hall, and will comply •uith these requiremc its. J ' Signed: For: Q d~ ~j~}'I Y1 (N une of Group or Organi2ation) I7ate• Approved; ----^- - Trywm Clerk Date: •.~ 06/06/2012 11:01 84548624$3 r ,. , DUTCi~SS + ~~UN'TY BOARD OF ELECTi4NS ~7 CANNON STREET PQ UG)FiKEEPSIE, NY 12601 WWW.I ~LITCHESSEEECTIONS.COM PAGE 01103 FACSII /dl~E TRANSMITTAL SHEET 7'O: Christinr: FROM: Dontta Shea, Senior Elections Specialist COMPANY: 'I'nwn of Wappingers DATE; 6/6/1.2 FAX NUMBEI.: 298.1478 TOTAL NQ. OF PAGES INCLUDING COVER: 3 PH07+1E NUMT3E1t: SENDER'S PHONE N[JMBFR: (845) 486-2474 RE: Facility U~:t. Farm SENDER'S .FA7C NUMBER: (845) 486-2483 _ URGENT _._ FOR REVIEW ___. PI'.~;A,SE COMMENT _ PLEASE REPLY _ PLEASE RECYCLE NdTESICO~rIMENTS: Hi Christi,r~e, Per our phone eanversatian of to ~~y, the Beard of. Elections would likE to hold training classes oz1, thy. following dates: J ly 19, 5: I5 -- $ PM & August 1.5, 9:15 AM to .r~oo~a. We also need tl,~e room for the Primary Election on September 1.3 froze. 1.1.:30 AM until 10 PM. I have attacht~d the Facility Use. k'orzn. Please notify me as soon as these dates are approved so ~9~at we can notify oa:r inspectors of these classes. Thank you. ;, ~' G°~C CSC ~M(~D JUN ~,6 2 ,:r`.1 ~;, ,. TOWN OF VVHPPINGER TOWN CLERK