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Facilities Usage Request Form

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Instructions: Facilities Usage Request Form must be submitted 30 days in advance of function.

Date: Ministry: Chairperson:
Contact Phone #: Date of Event: Time of Event:
Name of Event:     End Time:

Areas Requested:

Sanctuary
Fellowship Hall
Classroom
Meeting House
Nursery
Kitchen

Facilities Needs:

Parking Lot
Tables & Chairs
Paper Goods

Number of Participates: (must be filled out if supplies are needed)

Technical Support Needs:

Podium
Microphone
CD Player
TV/DVD Player
Projector
Screen
Extension Cords/Power Strips

Signature/Ministry Chairperson:

Date:

Note: All ministries are responsible for setting up and taking down tables and chairs for their event. Upon approval, signed and dated copies will be placed in ministry mailbox.

Copies Distrubuted to:

Ministry Chairperson
Sound Technician
Trustees

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Mount Zion
United Methodist Church
134 S. White Horse Pike
Lawnside, New Jersey 08045
Phone: 856-546-6334
Fax: 856-546-6340
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