Facility Request Form
Email address *
Event Name *
Your answer
Church Function *
Room Requested *
Your answer
Day of Week *
Date *
MM
/
DD
/
YYYY
Time *
Time
:
Responsible Person *
Your answer
Phone Number *
Your answer
Is the responsible person a church member? *
Number of Participants Expected *
Your answer
Is Childcare Needed? *
Number of Children Expected
If childcare is requested
Your answer
A/V Requested *
Description of A/V needed
If A/V is requested
Your answer
Key Requested *
Name of person to issue key to
Your answer
Preparation Date *
MM
/
DD
/
YYYY
Preparation Unlock Time *
Time
:
Preparation Lockup Time *
Time
:
Unlock the following outside doors for preparation
Select All That Apply
Lower Atrium Door
Upper Atrium Door
Sanctuary Door
Choir Room Door
FLC Door
1st Floor Stairwell
2nd Floor Stairwell
3rd Floor Stairwell
Kitchen Door
Event Entry Date *
MM
/
DD
/
YYYY
Event Entry Unlock Time *
Time
:
Event Entry Lockup Time *
Time
:
Unlock the following outside doors for event
Select All That Apply
Lower Atrium Door
Upper Atrium Door
Sanctuary Door
Choir Room Door
FLC Door
1st Floor Stairwell
2nd Floor Stairwell
3rd Floor Stairwell
Kitchen Door
Set-up/Special Instructions *
Your answer
Terms & Policies
Signature *
By signing, you agree to the above terms & policies (also located on our website) and agree to leave the room/facility as when arrived.
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
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