Building usage request form

Your Name:
Your e-mail address:
Your Phone number:
Your organization:
Date that you want to use the building:
Start time: End time:
Rooms requested (check all that apply):

Large hall Small hall Large dining room Small dining room
Kitchen Card room Balcony room Parking lot

Purpose of use (Dance, Installation, Party, change of date, etc)

Additional information or comments:

      * Please indicate in this box if this is an annual recurring event on a
          Fixed day (i.e. the third Saturday of June every year)

*Your e-mail address, name, phone#, organization, dates and times, and purpose of use must be filled out or this form will not process!

***Please keep in mind that stated meetings take priority over all requests. If you would like to schedule an event on the same day and times as someone else's event, please coordinate it with the other organization prior to submitting your request.***