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
 Choir Room
 Room 101
 Room 102
 Room 103
 Room 104
 Room 105
 Room 201
 Room 202
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 sponsor
Additional requirements/comments

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