2015-255-E Arts - Max Puhala Arts Grant

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DocuSign Envelope ID:684BD205-E201-4917-A887-C6D2D5CC92C7 .0 of the Triangle 001.jpg Binkley Baptist Church 1712 Willow Drive Chapel Hill North Carolina 27514 919-942-4954 office@binkleychurch.org _ BINKLEY BAPTIST CHURCH 2015 APPLICATION FOR USE OF CHURCH FACILITIES Binkley Baptist Church gives priority to and provides facilities for use by church members, non-profit organizations, civic and community groups and those whose mission and purpose are compatible with that of our church: Please use this form to request a room reservation. Once the form Is received you will be contacted by the office manager to confirm your reservation. Please note that church events have priority. Completion of this form does not guarantee your reservation.Thank yooq. Name of Group: o, Ric, of iVe, Contact Person: tt Email Address: t'�'� +�5.('t i +`� ' i �� I Phone Number: -S - Alternate Contact Person: (? 5 r,T , Email Address: W�r 'o ' • hone Number: —9 ci. rt How often will your group be meeting? f l- one time only , bi-weekly weekly monthly other -q� v Day(s)of the Week/Month needed: ,t " �YS art time End Lime: - 00 Room Requested: 57�,n F ocaYin Expected Attendance: FEE AND PAYMENTS(checks made payable to:Binkley Baptist Church) One Time Use: Payment Is due with application. Storage Fee:1 drawer in the Sun Room for$10 per month Monthly/Weekly Meetings:An invoice will be mailed on the first of the month for the previous month's usage to the group's designated contact.Payment is due upon receipt of the invoice. Room Fee v r1G? b = $W ao I have received,reviewed and understand the Binkley Baptist Church policies and guidelines regarding the use of the church facilities and equipment. l understand these policies and guidelines and I am signing as a representative of my group. I will review the policies and guidelines with my group. I understand that as a representative of my group I am responsible for the group while they are on church property.On behalf of the group I represent we agree to comply with these policies and guidelines during our use of Binkley church facilities, and understand that Binkley reserves the right to discontinue our usage of the facilities should we not do s Signature of User Group Representative Date DO NO PUBLICIZE ANY MEETINGS UNTIL YOU HAVE RECEIVED AUTHORIZATION. T h Administration h approved the use of the church f cilities for the purpose and dates listed. Sign u of Church Rep ese to ive Date a https://mail.g oog le.conVniai I/u/l/ffi`nboWl4dO74ce5eb6d7O9?projector=1 1/1