RECEIVED
BY
(OVER)
Revised January 29, 2021
EVENTS PLANNING MINISTRY (“EPM”) - 2021
A FACILITIES REQUEST FORM MUST BE COMPLETED IN ADDITION TO THIS FORM
THE BUDGET SECTION OF THIS FORM MUST BE COMPLETED OR IT WILL BE RETURNED TO YOU
A COPY OF THE THIS FORM WILL BE RETURNED TO YOU UPON APPROVAL OF YOUR EVENT
Name: ________________________________________ Ministry
Phone No. _______________(H) ________________(W) Title
Email Address: _________________________________ Budget
□ New Event □Cancellation □ Change
Title of Event ____________________________________________________________________________________________________________
Start End
Date ___________ Time: _________ _________ Early Set-Up Time: ___________ Break-Down Time: _____________________
HOW DOES THIS EVENT HELP BUILD THE KINGDOM?
Number of Attendees ___________
□ Ticketed Event
Price ___________
D
O YOU ANTICIPATE MAKING A PROFIT FROM THIS EVENT? NO____ YES____
IF YES, HOW WILL THOSE PROFITS BE USED?
Church Location: □ Shadyside □ Galilee South
Sanctuary
Classroom Number(s)
□ Mauve Room (a floor plan must be submitted to Facilities prior to the event)
□ Outside/Parking Area
□ Offsite
Travel Requested: City ___________________________ State
Transportation:
□ Church Van
□ Private Bus
□ Train
□ Air
□ Personal Volunteers
Additional Comments
Requestor’s Signature ______________________________________
□ Approved & Scheduled □ Not Approved
Reason(s) for Denial ________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Signed ________________________________________________ Date ______________________________________________________________
EPM Team Leader
(CONTACT THIS PERSON FOR ANY QUESTIONS OR CONCERNS YOU HAVE REGARDING YOUR EVENT)
