Community Bulletin Board/Channel 6

A service of the Columbia County Public Library

308 NW Columbia Avenue, Lake City, Florida 32055

Phone:  (386) 758-2101                                 Fax:  (386) 758-2135

columbiacbb@neflin.org

Please read Community Bulletin Board Guidelines on reverse before completing.  Text must be limited to a maximum of 65 words and should include specific date(s), time(s), and location(s).  Type or clearly print all information, and sign below.

OPTION:   o Attached separate sheet (flyer, ad, memo, press release, etc.) may be submitted instead of

completing the message section.

Message:____________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Organization information:

Name of Organization:  _________________________________________________________________

Services/Purpose:  _____________________________________________________________________

Physical Address/Brief Directions:  ________________________________________________________

                        ________________________________________________________________________

Mailing Address:  ______________________________________________________________________

 same as physical address ______________________________________________________________

Contact Name/Title:  ________________________            Daytime phone:________________

2^nd Contact Name/Title:  _____________________            Daytime phone:________________

Signature______________________________________________         Date:___________________

Rev 05/2010