Building/Facility Event Request Form
Please submit this form for all building requests
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Email *
Date of Application *
MM
/
DD
/
YYYY
Name of Person Requesting
Phone Number & Email
Name of Ministry or Organization
Proposed Usage Date(s) with Beginning and Ending Time(s)
[please include set-up/clean up time]
Purpose of Event
Event Location/Address 
CHURCH CAMPUS ROOMS REQUESTING
LIFE CENTER ROOMS REQUESTING
Captionless Image
How Many People You Expect?
[each day, if applicable]
Will You Need Any of the Following?
Are Musician Services Needed?
Clear selection
Are Ushers Needed?
Clear selection
Will a healthcare professional need to be in attendance?
Clear selection
Is Security Needed? (cost will be charged to your budget)
Clear selection
Any Other Special Request?
Name of Person Responsible for Event
Phone Number
Additional Comments/Request
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