Today's Date *

MM

DD

YYYY

Name of Responsible Individual *

First Name

Last Name

Phone *

(###)

###

####

Are you a member/attender of Salem UMC? *

Choose one.

Yes

No

Is this a reoccuring event? *

Choose one.

Yes

No

If yes, how often?

Daily

Weekly

Monthly

Event Start Time *

When does your event start? What time will your guests arrive? (Please don't include set up time)

Hour

Minute

Second

AM PM

Event End Time *

When is your event over? When will your guests leave? (Please don't include clean up time)

Hour

Minute

Second

AM PM

Set Up the Day Prior to Event *

Choose one and fill in the time you would need below.

Yes

No

Requested Room(s) *

Choose all that apply. If you need to cook during your event all cooking must be done in the Fellowship Hall Kitchen. (The parlor kitchen is not available for cooking)

Sanctuary/Chapel

Welcome Center

Fellowship Hall only

Fellowship Hall with use of kitchen

Parlor (Parlor kitchen is not available cooking. It must be done in Fellowship Hall Kitchen)

Nursery

Classroom

Work Room

Special Needs *

Choose all that apply.

Sanctuary PA System

Fellowship Hall PA System

Piano (if available in the room)

TV with HDMI

None

What doors will you use? *

Choose all that apply.

Welcome Center (access to the elevator)

Preschool

Office

Signature of Responsible Individual *

Type your name.

First Name

Last Name