Facility Use Request Form

Facility Use Request Form

Contact Person:  
Phone Number:  
Date and Time Requested:  
Purpose of Use and Type of Activities  
Space Requested:
  Original Facilities: □  Sanctuary
  □  Small Classrooms □  Large Classroom
  □  Kitchen □  Fellowship Hall
  New Facilities: □  Fellowship Hall
  □  Classrooms □  Kitchen
  Outside Grounds: □
Number of Persons Expected:  
Expected Duration (in hrs):  

This request is for:

One-time Use ____________

Occasional Use (Describe):  

Periodic Use (Describe):  

Long-term, Daily Use (Describe):  
Key Required ____ Yes   ____ No
Fee: $ _________


The undersigned states that he/she has been informed of the guidelines for use at St. Andrew Presbyterian Church facilities and that the use of these facilities will be in accordance with this application.  The undersigned further accepts responsibility for damage to church property caused by such use and for prompt and proper settlement of claims for such damage.



Signature                              Date                                  Signature                              Date




Head of Staff Signature          Date                     Clerk of Session Signature          Date

Clerk of Session signature is required if the request was forwarded to Session for approval.