Fac Request

 

REQUEST FOR USE OF FACILITIES

COMPLETE ALL INFORMATION AND PLACE REQUEST IN THE “ADMINISTRATION OFFICES INBOX” LOCATED JUST OUTSIDE THE ADMINISTRATIVE OFFICES ENTRANCE. PLEASE ALLOW 2-4 WEEKS FOR REVIEW.

1. Who 

Applicant's Name *

Applicant's Address *

Daytime Phone * (123)123-1234

Evening Phone * (123)123-1234

Name of Group/Individual Using Space *

Number of attendees *

Will event/meeting be (select one option)


2.  When

Date Requested (From) * (mm/dd/yyyy)

Date Requested (Until)   (mm/dd/yyyy)

Hours Requested (Open) * (ex. 11:00 am)

Hours Requested (Close) * (ex. 12:00 pm)

3.  Where & How

Room(s) and/or building spaces your are requesting use of *

If requesting outdoor space, other than normal parking, please describe your plans here

 

Special equipment needed (check all needed):

 Tables     Chairs     Audio/Visual Equipment     Sound Equipment     Kitchen     Other

Amount of Tables          Amount of Chairs          Specify A/V Equipment           Specify Sound Equipment           Specify Other
                           


Digital Signature

I have read and thoroughly understand all of the rules and regulations of the NLOI Policy that governs the use of the facilities and by entering my initials below I agree to have my group/ministry enforce all rules that are applicable to this use.