Conference Registration Form – Galway, NY. USA Please enable JavaScript in your browser to complete this form.Name of Contact(s) *FirstLastOrganization *Name of organization or community eventPhone Number *Alternate Phone NumberEmail *EmailConfirm EmailAre you non-profit *YesNoDo you have 501(c)(3) tax-exempt status?Date to Reserve Room *Time Requested From *24 Hour clock: 8:00 is am / 20:00 is PMTime Requested To *24 Hour clock: 8:00 is am / 20:00 is PMNumber of People Attending *Purpose of Room Use *Do you need use of equipment?None RequiredVideo ScreenOverhead ProjectorLaptop ConnectorSmartboardHDMI CableVGA CableALD HeadsetOtherPlease specify for Other equipmentSpecial materials you will be bringing *Example: Paint. clay, tools, etc.Will there be refreshments served? *YesNoAdditional InformationDo you need a specific room, or other anything else you want us to know about.Do you accept the Room Use Policy? *YesNoSignature confirming you accept the "Room Use Policy" You can print & sign this form and then email or bring to library, or you can sign the submitted form at the library on or before the requested date.Approval Date (Library Use Only ***)Notification Date (Library Use Only ***)Submit
