City of Victoria Form Center

2. Group/Individual Name
4. Contact Person
6. Address
8. City
9. State
10. Zip Code
12. Email
14. Purpose of Meeting
16. Check all that apply

    1. Meeting is being held by the City of Victoria department.
    2. Meeting is being held by a non-profit organization.
    3. Meeting is for educational or cultural activities.
    4. Meeting is open to the public.
18. Is there a registration fee or donation required to attend?

    1. Yes
    2. No
20. Are you selling any goods or services at the meeting?

    1. Yes
    2. No
22. Room Requested

    1. Meeting Room A (max. capacity 50 standing)
    2. Meeting Room B (max. capacity 100 standing)
    3. Meeting Room C (max. capacity 50 standing)
    4. Computer Lab (max. capacity 10 seated)
24. Equipment Requested

    1. Lectern
    2. Screen
    3. Video Conferencing
    4. Projector
    5. DVD Player
26. Date(s) of meeting
28. Meeting Start Time (include set up)
30. Meeting End Time (include clean up)
32. I have read and agree with the Victoria Public Library Meeting Room Policy.

    1. Yes

    I understand that I am responsible for setting up and putting away any furniture and equipment we use, and leaving the room in its original condition before the library closes. Failure to comply with these stipulations may result in denial of future requests to schedule the meeting rooms.

34. Note:
    • Not all equipment is available in all meeting rooms. 
    • Please contact the Service Desk at 361-485-3301 or vpl@victoriatx.gov for further assistance.
    • If you have questions about using or connecting to our equipment. It is recommended that you visit the library prior to your meeting to look at the equipment we have available. 
    • Library staff may not be available for assistance with equipment the day of the meeting.
    • See the Service Desk for any assistance needed on the day of the meeting.
    • You will be contacted once your request has been confirmed or denied.
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field