FACILITIES USE REQUEST FORM

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Facilities Use Request Form

Contact Person

Phone

Email

Mailing Address

Estimated # of Adults Attending

Estimated # of Youth Attending

Room(s) Requested:

Gym (Christian Life Center)

Stage (Off Limits to Unauthorized People)

Kitchen off CLC

Myers Conference Room

Sanctuary

Watson Hall

Other

Event Title

Member (Yes or No)

Organization

Event Description/Purpose

Date of Event

Event Start Time

Arrival time for Setup

# of Tables Needed:

Audio/Video Requested

Event End Time

Clean up is complete

# of Chair Needed

A/V Equipment Requested

Any further request notes:

Thanks for submitting! Our event coordinator will be in contact with you shortly!

MINISTRIES

Dardenne Presbyterian Church

7400 South Outer 364 Dardenne Prairie, MO 63368

(636) 561-4347

Church Office Hours: Monday thru Thursday 9:00AM-4:00PM

The office will be closed on Fridays.

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Dardenne Presbyterian Church ®