Building Usage Request Form
Name of organization or group*
Address of organization or group*
Is the organization incorporated?
Does the organization have liability insurance? (required prior to event)*
Your email address*
Date(s) of event*
Time of event (begin and end)*
Purpose of event/activity description*
Room choice*
 Taylor Hall
 Room 101
Do you plan to use the kitchen? If so, please describe usage. (deposit required)
Estimated number of people*
Ratio of children to adults (if applicable)
Name of church contact
Additional requirements/comments

First Presbyterian Church in Springfield - 1710 Bethlehem Pike - Flourtown PA 19031