NJC Application for Use of Facilities

Please complete the form below:

Date	*
Name of Ministry	*
Other

Title	*
First Name	*
Last Name	*

Cell Number
Email Address	*

From: Date	*
From: Time	*
To: Date	*
To: Time	*

Target Audience	*
Event Description	*

Location Desired:	*
Room(s) Desired:	*

Admission:	*
Cost Amount, if applicable

Select services necessary to accommodate this event:	*
Arrangements/Setup Requred (Be Specific)

I promise to abide by all policies, procedures, and other requirements for the use of New Jerusalem equipment and property.
Person Responsible for Activity	*