CITY OF LEWISTON, MAINE

FACILITY USE APPLICATION (LIBRARY)

COMPLETE AND RETURN TO: Director’s Office, Lewiston Public Library, 200 Lisbon St., Lewiston, ME 04240
with $50 application fee payable to City of Lewiston. [Organizations which want to make regular use of
Library conference rooms need only submit one application and fee payment for the entire fiscal year (July 1
thru June 30).]

May 28, 2018

Date of Application: ______________________________

The Church of Jesus Christ of Latter Day Saints

Organization: ______________________________________________________________________________

Elders
Contact Person: _________________________________________________ 207-312-3567
Phone: ____________________

370288709@mormon.org
Contact email: ______________________________________________________________________________

545 Maple Hill Rd, Auburn, ME 04240

Address: __________________________________________________________________________________

Free English Course

Description of Meeting or Event: _______________________________________________________________

Tuesdays and Thursdays

Event Dates: _______________________________________________________________________________
5.30pm
Event Time: Begin: _________________ 6.45pm
End: __________________
X
Space requested: ___Callahan Hall ___Couture Room ___3rd Floor Conference Room ___Computer Lab

10-15
Anticipated attendance (estimate): _________________
Admission Fee/Donation? ___Yes ___No X If yes, specify amount: $__________________________________
Will services or products be available for sale at the event? ___Yes ___No X If yes, provide details:
__________________________________________________________________________________________
Age restriction on admission? ___Yes ___NoX If yes, give details: ____________________________________

USE CLASSIFICATION REQUESTED:

___ Commercial A (revenue producing)
___ Commercial B (non-revenue producing)
___ Non-Profit A (revenue producing)
___
X Non-Profit B (non-revenue producing)
___ Exempt (Lewiston non-profit or government; application fee will not be waived)

_______________________________________________________ May 28, 2018

_____________________
Signature of Applicant or Authorized Representative Date

$50 application fee due with all applications. Room rental fees based on space being used and the use classification. Lewiston non-
profits or governmental agencies may be exempt from conference room rental fees. For details, consult the City of Lewiston Facility
Use Policy or contact the Library Director’s office at 513-3119 or LPL@LewistonMaine.gov