Please read through our Community Room Policy before submitting a rental form. The community room should be reserved, and the form below completed, at least 48 hours in advance of the event. Non-library events may not be scheduled more than two months in advance of the event. Deposits must be made at the time of scheduling. 

Library Community Room Location (circle one):      

Pemberville        Stony Ridge          Luckey  

Name of Group: _________________________________________________

Type of Group/ Purpose of Event: _____________________________________

Date of Event: ______________         Time: _______________to _____________

Representative of Group: _________________________________________________

Representative’s Home Address:____________________________________________

_______________________________________________________________________

Representative’s Phone Number: ____________________________________________

Library Staff Use Only 

$40 Fee Required: YES   /  NO                   $40 Fee Received on (date): ______________

                                                                       Staff Initials: ______________ 

$40 Deposit Required:  YES  /  NO              $40 Fee Received on (date): ___________

                                                                             Staff Initials: ______________ 

Community Room Key Picked Up (if applicable) on (date): _______________________ 

                                                                          Staff Initials: ______________