CFM Facility Use Application

Concord Friends Meeting

11 Oxbow Pond Rd, Canterbury NH 03224

PropertyCommittee [at] ConcordFriendsMeeting [dot] org

Application for Facility Use

Name of Organization or Individual Renting or Using the Facility: Name of Responsible Person: Name of Contact (if different): Mailing Address: Zip: Phone: Cell: Work: Home: E-Mail:

Event Name and Description:

Type of Use:

Type 1 Type 2 Type 3 Type 4

Number of participants anticipated: Date(s) Requested (provide alternates if you are able.):

Start Time: End Time:

Our group has a general liability insurance policy: YES NO

How often will the event occur?

One time only Monthly Weekly Multiple Days

Which days of the week? (check all that apply)

Rooms(s)/Services Requested:

Hospitality for Type 1 uses only: Would you like hospitality if it can be provided?

YES NO

Type 1 uses only. Please describe hospitality needs of your group:

Do you expect children to attend your event?

YES NO

The Meeting asks Type 1, 2 & 3 users to return the facility to the state it was in prior to. This includes returning furnishings, equipment and supplies to the locations they were in at the start of your event and light cleaning. Please sweep, mop up spills, vacuum carpets, and wipe down counters, sinks, and appliances used.

By submitting this application, I acknowledge that I have read the Facility Use Policy provided me, and I accept responsibility to ensure our use adheres to the Policy.

Signature or Name (if submitted electronically): Date: