Building Use Request Form
Filling out this form does not guarantee usage of the space. The building manager must approve all requests and will be in contact after review. In order to ensure that your request is completed when desired, please give us at least two week’s notice.
Name
First Name
Last Name
Email
example@example.com
Phone Number (Cell Preferred)
-
Area Code
Phone Number
Best Time to Call
Morning
Afternoon
Evening
Anytime
Name of Event
Date of Event
-
Month
-
Day
Year
Date
Start Time (include set up)
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
End Time (include clean up)
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
How many people will be at this event?
Please describe your event:
What room(s) would you like?
Palmer Room
Tucker Room/kitchenette
Henry Room/kitchenette
Family Room
Childley Hall
Kitchen
Ripley Chapel
Sanctuary
Not sure (FCC will assign a room appropriate for your request)
Submit
Should be Empty: