GCC Key Loan Application
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Description / Name of Group / Function
*
example (Elder, Home Group Leader, Ministry Team)
List the Rooms Needed for Access
*
Key Loan Time
*
Temporary - Will Return on the Date Indicated Below
Perpetual Use
Date for Key Return
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Borrower agrees to comply with the terms set forth below
*
YES
Keys are stamps with "DO NOT DUPLICATE." I agree to NOT make any copies of my key.
*
YES
I agree to NOT loan my key to another individual.
*
YES
Borrow Signature (type full name)
*
Date Given
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Key Type
Key #
Comment
Submit
Should be Empty: