Required fields are marked with a red asterisk (*). Applicant Name: * Organization Name: * Organization City, State ZIP: * Organization Website: * Organization Primary Contact Name: * Organization Primary Contact E-mail * Organization Primary Contact Phone: Organization Secondary Contact Name: Organization Secondary Contact Phone: Purpose of Meeting/Activity: * Anticipated Number Attending: * Date Requested: * Month MonthJanFebMarAprMay Day Day12345678910111213141516171819202122232425262728293031 Year Year2018 The McCallum Room may be booked up to two months in advance. Start Time: * Hour Hour123456789101112 : Minute Minute0030 am pm End Time: * Hour Hour123456789101112 : Minute Minute0030 am pm Is your organization a non-profit entity? * Yes No Please list type of non-profit category and tax exempt ID number, if applicable. Is the meeting open to the public? * - Select -YesNo Will there be a charge, donation, or admission to attend? * - Select -YesNo By submitting this application, I affirm this group or organization is non-profit, non-sectarian, and non-partisan. * Agree CAPTCHAThis question is to prevent automated spam submissions. What code is in the image? * Enter the characters shown in the image.