Facility Use Request Form
Greater Mount Moriah is very pleased to allow the use of our facilities. Please complete this form and return to the Church Clerk.
Requestors Name
First Name
Last Name
Are you a Member or Non-Member?
Please Select
Member
Non-Member
Email
example@example.com
Phone Number
Please enter a valid phone number.
Start Date of Event
-
Month
-
Day
Year
Date
End Date of Event
-
Month
-
Day
Year
Date
Ministry Name
Name of Event
Type of Event
Please give a brief description of your event.
Event START Time
Hour Minutes
AM
PM
AM/PM Option
Event END Time
Hour Minutes
AM
PM
AM/PM Option
TIme Needed for Setup
Do you need security?
Please Select
Yes
No
Facilities Needed (Check All that Apply)
Sanctuary
Family Life Center
Kitchen
Classroom
If Classroom is selected, please note the room number
Services Needed
None
Audio/Visual System (Fee applicable)
Set-Up Assistance (Fee applicable)
I agree that all guests must display the appropriate behavior, attire and language while on the church premises
Yes, I agree and understand
No, I do not agree and understand
I agree and understand this is an alcohol and drug free campus.
Yes, I agree and understand
No, I do not agree and understand
Submit
Should be Empty: