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. Date of Request <br />~. <br />APPLICATION FOR BUILDING USE <br />Person or roup requesting building ~~ <br />g <br />Date requested ~-~ •• •- <br />Beginning Time " • ~ Ending Time ~ := ~'•~ •~ "- - <br />' Purpose for request ~' •' <br />Describe briefly the activity to take place;. •• • <br />- Will there be an admission fee?' ~ ~~• "-••- <br />Approximately how many adults' - •, teens or children <br />do you plan to have in attendance? <br />Will you need tables or chairs? yes no . <br />If~yes, how many chairs , banquet tables or card <br />tables will be needed? <br />List other equipment needed if any, here: ~•~ ~ • <br />. .... .. . <br />Please use back bf form, if needed, to make diagram of set up. . <br />I have read and agree to abide by the attached policies for use of ~ "• <br />the building. I understand that I am responsible for any accidents <br />or damages that may occur during the time I have the building rented. <br />_ • I also understand that the key is to be returned the morning of the <br />. next working day:'';. <br />- ~ Signature' ~ . ' ~ • . - . . <br />Address .~ - <br />Room assignment <br />_"Key issued <br />Date returned ' <br />Condition of building <br />DATE ~ DEPOSIT <br />vATE RENTAL <br />~. _ ._ <br />Home Phone ' <br />Work Phone ~ '' <br />