NCIPHC Facility Use Request

Please take your time when filling in your request. 

Sign in to Google to save your progress. Learn more
Email *
Please explain the purpose of your event *
Today's Date *
MM
/
DD
/
YYYY
Please list in detail how you would like the following buildings set up if you chose them: J.A. Culbreth Auditorium, Cafeteria Training Center, Canteen. Failure to do so, will result in buildings being set up in their normal stage. If no set up is needed, please list so.

You will receive an email notification within 48 hours of your request. You will be notified if your request has been approved or not approved. 
*NCIPHC reserves the right to refuse any request*

Request made within 7 days prior to a requested date(s) of use, may not be approved. 

A 10% deposit must be made in order to reserve any building(s) after request has been approved.

As of July 2019, All NON IPHC Members/Ministries must provide Proof of Liability Insurance for their group in order to use NCIPHC Facilities. 

If you have any questions, please call Nicole Oliver (910) 980-1162 or email noliver@nciphc.com 

*
Phone # *
Please choose the following building(s) you would like to request use of: *
Required
Starting Date *
MM
/
DD
/
YYYY
If you chose Sudie Butler Guest House, please list how many rooms you will need: 8 Totals
Ending Date *
MM
/
DD
/
YYYY
Ending Time (Guest House 11AM) *
Time
:
Address (Street, City, State, Zip *
Ministry/Organization Name *
Starting Time (Guest House 4PM) *
Time
:
Your Name  *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy