BUILDING USE APPLICATION AND AGREEMENT

Name of Organization

Name of Organization :: org. name

Organization's Purpose

Organization's Purpose :: org. purpose

Non-Profit Status

Non-Profit Status :: non-profit status

Federal Tax ID No.

Federal Tax ID No. :: tax ID?

Event Name

Event Name :: event name

Event Date(s)*

Event Date(s) :: event dates

Number of Participants Expected

Number of Participants Expected :: numbers?

Will participants be charged a fee?

Yes
No

If yes, then how much?

Fees charged :: fees?

Event Description

Event Description :: event description

Responsible Person

Responsible Person :: person responsible

Address

Address :: street, city, zip

Daytime Phone

Daytime Phone :: Phone?

Fax if available

Fax if available :: Fax, if available

E-mail

E-mail :: e-mail

Signature of responsible person denoting agreement to terms

Date

Signature of Minister or Board Member

Date