Building Use Request

BUILDING USE REQUEST FORM
Clifton Park Baptist Church
8818 Piney Branch Road
Silver Spring, MD 20903
Office: 301-434-2456 Fax: 301-434-4114
Date Submitted:
Organization/Name of Requestor:*
CPBC Member:*

yesno
Address:*
City & State:*
Zip:
Phone Number*

Area CodePhone Number
E-mail*
Type of Function:
Expected # Attendees:
Event Date(s):
Time Desired:
(Include set up / clean up time)
Areas Desired:*

SanctuaryGymFellowship HallSocial HallClassroomsYouth RoomKitchenOther
Will you need to have the stove/oven lit for you?

NoYes
Will you need a Trustee to let you into the building?

NoYes
SET UP AND CLEAN UP IS THE SOLE RESPONSIBILITY OF THE PERSON(S) REQUESTING USE OF THE CPBC FACILITY.
Should be Empty: