Building Use Request Form

First Name

Last Name

Email

Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Name and Purpose of Event

Is this event

This event is

Event start date

Event end date

Event start time

Event end time

How much set-up and tear-down time will you need before and after the event?

How often does this event occur?

Number of participants expected