MDUMC Room Request
Primary Contact
First Name
Last Name
Organization using the room
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Can you provide proof of non-profit designation?
yes
no
Can you provide a certificate of insurance?
yes
no
Date(s) needed:
Time needed:
How do you intend to use the room/building?
How many people will attend and how do you need the room set up?
Expand on the organization and its purpose or role in the community:
Submit
Should be Empty: