Saint John AME, 708 15th Street North, Birmingham, AL 35203
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Facility Use Form
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Facility Use Form
Facility Use Form
Company
This field is for validation purposes and should be left unchanged.
Facility Use Request Form
1. Organization or person requesting use:
name of the organization or the applicant
2. Type activity:
3. Activity Date:
MM slash DD slash YYYY
4. Time of Activity:
Hours
:
Minutes
AM
PM
AM/PM
Activity Day:
5. Time church needs to be opened:
Hours
:
Minutes
AM
PM
AM/PM
6. An approximate time church can be closed:
Hours
:
Minutes
AM
PM
AM/PM
7a. Areas of the church to be used:
Sanctuary
Fellowship Hall
Conf. Room
Kitchen
7b. Another area of the church to be used not listed in 7a:
8. An approximate number of attendees:
9. Attendes:
Adults
Children
10a. Is this a recurring activity?
yes
no
10b. If yes, how often will activity take place?
Weekly
Monthly
Quarterly
Annually
As Needed
Other
10c. If the activity is recurring and will take place on the same day of the week, what day of the week will it take place?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
10d. If another frequency, please input:
11. Will food be served?
yes
no
12. Will the kitchen be used?
yes
no
13a. Will set-up be required?
yes
no
13b . If yes, in which space will the equipment be used?
Tables
Chairs
Other
14a. Will audio/visual equipment be used?
yes
no
14b. If yes, in which space will the equipment be used?
Sanctuary
Fellowship Hall
Class Room
Conference Room
Other
14c. If other, please input:
14d. Will any needed audio/visual equipment be provided?
yes
no
14e. If yes, what audio/visual equipment is needed?
15. Other comments:
Signature of Applicant/Contact:
Telephone
Date
MM slash DD slash YYYY
Signature of Second Applicant/Contact:
Telephone
Date
MM slash DD slash YYYY
Email
Note: if the activity is canceled, please notify the office at least 72-hours prior to the activity.
This Section for Church Use Only
Approved/Confirmed by__________________________
Approved/Confirmed date ________________________
The Assigned Trustee ___________________________
Trustee phone _________________________________
Items below are completed only for facility rentals
Deposit Date _________________________________
Full Payment Date ______________________________
Applicant Notified by____________________________
Notification Date ________________________________