ROOM REQUEST FORM

ROOM REQUEST FORM
Date Form filled out

MonthDayYear
Filled out by

First NameLast Name
Date requested

MonthDayYear
Additional Dates if needed
Time Requested - Begin (includes set up time)

:HourMinutesAM/PM Option
Time - End (must end by 9:15 pm)

:HourMinutesAM/PM Option
Room Requested
# expected at meeting:
Childcare

Childcare needed (Must request at least 3 days prior to meeting)Childcare not needed
Metting Approved by

First NameLast Name
Date Approved

MonthDayYear
Keys given
NO CHARGE FOR HCUMC SPONSORED EVENTS OR MEETINGS.
Contact person day of event

First NameLast Name
Home Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
E-mail
Comments or Special Requests
I have read the church policy on building use and will assume responsibility for my organization’s/committee’s compliance.

NOTE:

The room must be returned to its original condition.

All lights must be turned off.

Trash cans must be emptied and taken to the dumpster if they contain food.

Air conditioner/heater thermostats should be reset to their original setting.

Please be courteous and considerate of other groups around you who are also conducting their programs.
Signature

First NameLast Name
Date Signed

MonthDayYear
Should be Empty: