Facility Use Request Form
Please complete form as far in advance of date requested as possible.
Email address *
Member *
Is the person requesting use of the Alive In Christ Facility a member of Alive In Christ?
Who is this request for? *
Is it for a board/group or for an individual member use?
Name *
Your answer
Address
Your answer
Phone Number *
Your answer
Member, who will be responsible for event *
Your answer
Will member above be present at event?
Start Date *
MM
/
DD
/
YYYY
End Date *
MM
/
DD
/
YYYY
Start Time *
Time
:
End Time *
Time
:
If recurrence, how frequent? *
(e.g. every 3rd Sunday or ever 2nd & 4th Tuesday)
Thermostat adjustment requested (If other than normal temperature range)
Building Access Requested
I have building access? (key/card)
Facilities needed (please check all of the rooms requested)
Special room arrangement requested
Your answer
Equipment needed
User provided equipment (listed above or other)
Your answer
A/V technician support requested
Estimated # of people attending
Your answer
Please explain activity to be held *
Your answer
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