Covenant Building Usage Request Form
Covenant Lutheran Church
1525 N. Van Buren Street
Stoughton, WI 53589
(608) 873-7494
covlutheran@gmail.com
Email address *
Name of Organization: *
Your answer
Organization Type: *
Type of request/purpose: *
Your answer
Date(s) of event: *
Your answer
If a recurring date, please state the first date, frequency of recurrence and end date, ie: 8/6/2019, first Tuesday each month until 8/5/2020
Your answer
Start time: *
Time
:
End time: *
Time
:
Number of persons anticipated to be present for this event: *
Your answer
Will participants be charged for this event? *
If yes, what amount?
Your answer
Requested space (check all that apply): *
Required
Choose an exterior door to open: *
Alternate open/lock times are requested
Exterior doors are programmed to open 1/2 hour before the event and lock 15 minutes after the event. Please let us know below if you have a special request that is different.
Your answer
Supplies needed: *
Required
Any special notes for room set up?
Your answer
Contact Person: *
Your answer
Contact Phone Number: *
Your answer
Contact Email Address: *
Your answer
Contact Person Address: *
Your answer
Person(s) responsible for set-up: *
Note: it is understood that the person in charge will be responsible for 1) set-up, 2) take-down, and 3) clean-up. A $50/hr janitorial fee will be charged if not done.
Your answer
Person(s) responsible for clean-up *
Your answer
Please indicate that you have read the requirements for the building usage. https://docs.google.com/document/d/1KaiJAeJe8ODKo-kMa7gZsnLpFazondrJpqxVUlyMcA0/edit?usp=sharing *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service