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Request Form for Special Building Use Of Central Presbyterian Church
Please complete this form so we can determine if we can accommodate your needs.
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* Indicates required question
Today's Date:
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MM
/
DD
/
YYYY
Name:
*
Your answer
Organization Name:
*
Your answer
Contact Name:
*
Your answer
Contact Phone Number:
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Your answer
Contact Email:
*
Your answer
Requested Date of Use:
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MM
/
DD
/
YYYY
Requested Start Time of Use:
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Time
:
AM
PM
Requested End Time of Use:
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Time
:
AM
PM
Description of Activity/Event:
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Your answer
Reason to Use this Facility:
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Your answer
Number of Adults Attending:
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Your answer
Number of Children Attending (must be supervised):
*
Your answer
Are Central Presbyterian Members Involved?
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Yes
No
Required
If Yes, please provide names of CPC Members
Your answer
Requested area of church
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Sanctuary
Parlor
Undercroft
Choir Loft
Required
Will the Piano and/or Organ be needed?
*
Yes
No
Required
After Use Cleaning Plan
*
Self clean
Hire for Fee
Required
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