Public Display Case Reservation Request Form

Name (Organization or Individual):

Address:

Telephone:

Email:

Briefly describe the nature and purpose of the display:

Please mark your first and second preference for when you'd like to reserve the cases:

First Preference:
JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Second Preference:
JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

I have read, understand and agree to abide by Waukesha Public Library Policy B-3 Public Display and Exhibit Space. I agree to assume responsibility for the display and to ensure that it is set up and removed on time.

Thank you for submitting your request. A request for reservation implies that both cases will be used to exhibit. Scheduling is determined by a panel of the Administrative Team and Chair of the Public Art Committee as time and space permit. You will hear in approximately one month whether the display case is reserved for you.

Typing your name will serve as a signature for this form.

Signature of Liaison/Sponsor: Date:

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