Facility Usage Request Form
You will be informed within five business days if your request is approved. Once you submit your form, you must submit the application ($15.00 non-profit or $25.00 other). If fee is not received within 5 business days of submission, we will cancel your request. Internal or external event applicants will be required to sign a Use of Premise Agreement, provide a certificate of liability insurance and may be charged application, deposit and other applicable usage fee. Please review rental pricing sheet below.
Email address *
Please see room rental fees (subject to change)
Type of event: *
Please briefly describe your event.
Your answer
Name *
Your answer
Organization *
Your answer
Address *
Please include your full address, including city, state and zip code.
Your answer
Phone *
Your answer
Email *
Your answer
Name of Payor (if different than above)
Your answer
Payor's phone number
Your answer
Payor's full billing address
Your answer
How did you hear about SEI? *
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of Self Enhancement, Inc.. Report Abuse - Terms of Service - Additional Terms