Facility Use Application
Today's Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name of Group:
Your Name:
First Name
Last Name
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone:
Format: (000) 000-0000.
Cell:
Format: (000) 000-0000.
Email:
example@example.com
Organization Type
Business
Non-Profit
Personal
Requesting:
1. Date(s) of event:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Start Time
Hour Minutes
AM
PM
AM/PM Option
End Time
Hour Minutes
AM
PM
AM/PM Option
Setup Time
Hour Minutes
AM
PM
AM/PM Option
Break Down Time
Hour Minutes
AM
PM
AM/PM Option
ALTERNATE date(s)
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
2. The purpose of this use will be:
3. Anticipated maximum attendance: Adults
Youth (17 and under)
Total
4. Will there be an admission charge, sale solicitation, donation, or collection involved with your use?
Yes
No
5. Is this a fundraiser?
Yes
No
(FUNDRAISERS REQUIRE SESSION APPROVAL IN ADVANCE)
6. Will there be decorations?
Yes
No
If yes, describe them
7. Food Services:
Kitchen Needed
Tea/Coffee Only
Buffet
Sit Down/Full Service
If catered, provide name and contact information of caterer:
8. Rooms Needed:
9. Resources Needed:
10. Fellowship Lounge-Sound Proof Door Needed?
Yes
No
11. How many chairs and tables will you need? (Rectangular fits 8-10 seating, Round fits maximum 8 seating) Rectangular Tables
Round Tables
Chairs
12. Audio Visual Requirements:
13. Publicity:
Facebook
Flyer/Insert
Plugged In
Mailing
Banner
Sunday Table
Announcement
Website
14. Who will be the on site person / people in charge on the day of the event?
1.
First Name
Last Name
Phone:
Format: (000) 000-0000.
2.
First Name
Last Name
Phone:
Format: (000) 000-0000.
15. Program Planner
Name:
First Name
Last Name
Phone:
Format: (000) 000-0000.
16. Promotion Planner
Name:
First Name
Last Name
Phone:
Format: (000) 000-0000.
Return this application for approval.
You will be contaced within 5 working days.
October 2026
Preview PDF
Submit
Should be Empty: