Today's date:__________
Name of organization: ____________________________________________________
Requested date(s) of building use: __________________________________________
Time(s) requested: ______________________________ **
** Please note that space will be available only for the date(s) and time frame
which are requested & approved. If set up or tear down for your event is
required, please factor that into your request. **
Contact person: _________________________________
Mailing address: ______________________________________
Phone: _____________________ E-mail address: ____________________
What is the event? ___________________________________
Is this a for-profit or fundraising activity? _________
What space are you requesting? {Please circle all applicable): **
Fellowship Hall, Large Classroom, Small Classroom, Other (please identify “other”:
__________).
** Our Church is a busy place. Please note that only the space(s) requested
and approved will be available for your organization’s use during the
time frame requested and approved. **
Will you need to use the kitchen? ____________ To use the kitchen you will need permission from the Ladies Aid Society. Please contact Judy Duval at 372-4393 or Patsy Robinson at 372-4364 for permission and instruction.
Do you need a key to open and lock building? ___
Name and phone number of person in your organization in charge of clean-up: __________________________________ phone: ______________
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Additional notes or explanations (if any): ____________________________________
_____________________________________________________________________
Please note instructions for trash removal, which are posted in the kitchen area. These trash removal instructions apply to all areas of the building that you are using. Please leave all spaces clean and in orderly condition.
Please mail or e-mail this form to the Board of Trustees at the above address for their consideration. The Board of Trustees meet on the Third Tuesday of the month. Applications should be received prior to these regularly scheduled meetings.
We believe it to be a mission of this church to serve the needs of this community by making our space available. Understand that it is costly to maintain a building and provide utilities (heat, light, water, kitchen equipment) and consider that contributions are gratefully accepted.
Suggested minimum contributions:
$20 per classroom per use
$50 for Fellowship Hall per use
$60 for kitchen per use
I have read the provisions contained in this agreement, as well as clean up
responsibilities, and accept them as stated. I further understand that church
functions and activities take precedence over other community uses, and that
at times such church functions may preempt previously approved community uses.
Date: _______________ Representative's signature: _______________________________
Approved: ___________ Date: _____________