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Meeting Room Reservation Form

  1. Will you be the person checking in for the meeting?*

  2. Do you have a Kearney Public Library card?

  3. Does the check-in representative have a Kearney Public Library card?

  4. Is there another check-in representative?*

  5. Please include set-up and tear-down time in your request.

  6. Would you like to request multiple meeting dates?

  7. Available amenities:*

  8. Items you will provide:*

  9. Policy Agreement*

    As an authorized adult representative of the above organization, by selecting "agree," I hereby apply for the use of the meeting room as indicated above. I have read the policies and rules governing the use of the meeting room facilities and agree that they will be carefully observed. If a meeting is canceled, I agree to notify the library as far in advance as possible.

  10. Please Note: A confirmation email will be sent once the meeting is approved.

  11. FOR LIBRARY USE ONLY

  12. Application Approved by:

  13. Date Approved:

  14. Assigned Room:

    Loup / North Platte / South Platte / Niobrara

  15. Contact Signature:

  16. Deposit Paid

    Cash Check

  17. Deposit Returned

    Yes / No / Donated

  18. Contact Initials

  19. Library Staff Initials

  20. Leave This Blank:

  21. This field is not part of the form submission.