This Form is only for USSB Members requesting a Room to Reserve.  Thank you.

    If this Request is for a Personal Event or for an event for an organization you are working with, please use the non-Member, regular Room Use Request Form.) (required)

    Event Title (required) (This will appear on our Schedule.)

    Brief Event Description (required)

    Contact First Name (required)

    Contact Last Name (required)

    Phone Number

    Your Email Address (required)

    Will your event take place on a Single Day?


    What is the Date of your Single Day Event? (m/d/yyyy)

    If your Event will take place over Multiple Days, please enter the First Date and Last Date below:

    First Day of Use?

    Last Day of Use?

    About how many people are you expecting will attend?

    Describe the Frequency of your Event: (2nd Thursday of the month; Every other Monday; OR the exact dates if there is NOT a pattern of ongoing dates.)

    Time of Day You Need the Room (To begin setting up):

    Time of Day Your Event Will Begin:

    Time Your Event Will End

    Time You Will Leave the Room

    Which of our room(s) do you want to rent? (see list below; hold CTRL + Click to select multiple rooms)

    Alcohol Being Served?


    Food and/or Non-Alcoholic Beverages Being Served?


    If you answered YES to either Alcohol OR Food being served, please provide details here:

    Projector Needed?


    IF YES - Source of Your Video (DVD, Laptop, other)

    Sound System Needed?


    IF YES - Source of Sound (DVD, Laptop, Cell Phone, other)

    Kitchen Required?


    Do you need to have a USSB Staff member available to:

    (USSB requires some events to be Staffed. You will be notified if this is the case before entering into a rental agreement.)

    Might your Room Use impact other Room Users or the Church's residential neighbors? (Will you have amplified music, be showing a film, have people coming and going frequently, conducting a drum circle, etc.?) Please let us know of any activity that might "go beyond your room". Thank you very much.)


    If Yes, please explain:

    Setup Instructions, Special Requests, Comments or Questions.
    ALSO PLEASE NOTE!! Parish Hall and Jefferson Hall are NOT setup with tables and chairs. You can do the setup and take-down yourself, or assistance can be provided for a fee. Please provide any details you believe are necessary for the room to meet your expectations. Thank you.