301-577-1092 • E-mail: office.gpc@verizon.net
APPLICATION FOR USE OF CHURCH FACILITIES
AND EQUIPMENT
NAME OF APPLICANT/MEMBER OF GRACE PRESBYTERIAN CHURCH_________________________________
ADDRESS ________________________________________________________________________________________
PHONE ____________________________________ (OFFICE) ______________________________________
ORGANIZATION REPRESENTED ___________________________________________________________________
PURPOSE OF EVENT ______________________________________________________________________________
FOR WEDDINGS: PASTOR OFFICIATING ___________________________________________________________
PASTOR PHONE NUMBER ________________________________________________________
PASTOR CHURCH NAME _________________________________________________________
PASTOR CHURCH ADDRESS ______________________________________________________
APPROXIMATE ATTENDANCE EXPECTED _______________________
DATE(S) REQUESTED ____________________________________ TIME: From ____________ To ____________
____________________________________ TIME: From ____________ To ____________
FACILITY REQUESTED
q Sanctuary q Small Meeting Room
q Fellowship Hall q Classroom
q Pantry/Kitchen q Other: ___________________________________________
q Nursery
EQUIPMENT REQUIRED (tables, chairs, slide projector, etc.) ______________________________________________
USE OF KITCHEN
q Full Meal q Coffee Only
q Refreshments/Dessert q Not needed
KITCHEN PREPARATION
q Applicant will use church kitchen
q Food must be prepared elsewhere to be served from our church kitchen
q Outside caterer: Name & Phone Number: _______________________________________________
Upon approval of the application, the contract on the attached sheet will be observed and the Grace Church MEMBER signing this application will assume all responsibility for damage, loss, or other liability arising from the use of the facilities. The MEMBER will be on site the whole time the facility is being used.
APPLICANT/MEMBER SIGNATURE ____________________________________ DATE _____________________
CHURCH APPROVAL SIGNATURE
_______________________________________________________ ________________________________________
Ian Shantz, Elder, Administration Committee Date
301-262-8437
OFFICE USE
ONLY
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Key Issued _________________ Rental Fee ______________ Check Number _______ Date _______
Key Returned _________________ Security Deposit
$200.00 Check
Number _______ Date _______
Equipment Rented _________________ Key Deposit $10.00 Check Number _______ Date _______
Equipment Returned _________________ Security Deposit Returned Date ____________________________
Clean-up Satisfactory q YES q NO Key Deposit Returned Date ____________________________