Midtown Community Center Space Use Request
Thank you for your interest in the Midtown Community Center. Please complete this application to help us get to know your organization and space needs better.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Organization Name
Non-Profit Tax ID or EIN
What is the mission of your organization?
Organization web address
What population(s) does your organization primarily serve?
Food insecure
Education insecure
Economically insecure
Spiritually insecure
Other
Other population(s)
What type of space are you interested in?
Office space
Desk space
Meeting space
Event space
Please tell us about your interest in a membership and intended use of the space, including who and how many you may serve.
How will you pay for your membership?
Please Select
Credit Card
Credit Card on file
Check
Liability Insurance
Browse Files
Drag and drop files here
Choose a file
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References
General Reference Name
First Name
Last Name
How do you know the above reference?
General Reference Email (Board Member, participant, etc.)
example@example.com
General Reference Phone Number
Please enter a valid phone number.
Financial Reference Name (Board Member, Accountant, etc.)
First Name
Last Name
How do you know the above reference?
Financial Reference Email
example@example.com
Financial Reference Phone Number
Please enter a valid phone number.
Submit
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