Facility Request Form
Please Note: All Requests Are Pending Approval
Type of Request
*
Facility Usage
Ice Cream Truck Rental
Other
GROUP INFORMATION - Type of Group
*
Union Baptist Church Ministry
Community Organization
Other
Event Name / Type of Event
*
Group Name if Applicable
Contact Name
*
First Name
Last Name
Contact Number
*
Format: (000) 000-0000.
E-mail
*
Confirmation Email
example@example.com
If this a recurring meeting, please list the day and time that it occurs, ex. monthly meeting every 3rd Saturday at 12 pm, weekly choir rehearsal every Wednesday at 6:30 pm, etc.
Event Date
*
/
Month
/
Day
Year
Date
Event Time
*
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Expected Attendance
*
Rooms Needed
*
Room 201
Room 202
Room 203
Room 204
Room 210
Multi-Purpose Room
Kitchen
Room 207
Peoples' Chapel
Sanctuary
Room 139
Other
Resources Needed
*
Sound
Audio/Visual Equipment (Additional Fee)
None
Other
Is This a recurring event?
Yes
No
If yes, please list the dates and times.
Please list Room Set-up Style, Number of people and Additional Comments
*
i.e., Room 201 - Meeting/Lecture Style - 40 people,
Optional: Attach Layout
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Agreement & Signature I understand that submission of this form does not guarantee approval. All facility usages are subject to church policies and availability.
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