Room Usage Form

Today's Date:

ROOM USAGE REQUEST FORM
WILLOW GROVE UNITED METHODIST CHURCH
34 North York RoadWillow Grove, PA 19090
(215) 659-3232

ORGANIZATION/GROUP NAME:
DATE REQUESTED:        TIME:           __                _____

ALTERNATE DATE AND TIME (if date requested is unavailable)                                   _______

PURPOSE:
ROOM/S REQUESTED:                          ______________________________________________

APPROX. NUMBER OF PEOPLE: __         _____

FEE: YES/NO          AMOUNT: _______________________

IS THIS GOING TO BE THE SAME DAY & TIME EACH MONTH/WEEK?   YES / NO

CONTACT NAME:    _____________

ADDRESS:
PHONE #:     WORK #:

NOTES: ________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

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APPROVAL FORM For: ______________________________DATE: _______TIME: _________
(insert rooms to be used)
APPROVED BY:
          SECRETARY            TRUSTEES              PASTOR
DATE APPROVED:                                                    COPY OF APPROVED FORM TO
FEE AMOUNT (if applicable): ___ ___________         TREASURER _______________
RECEIVED BY:___________________________         DATE:____________

Room Usage Request Form