Room Request Form

PLEASE NOTE THAT ALL ROOM REQUESTS ARE NOT CONFIRMED UNTIL YOU HEAR BACK FROM US.

If your request is approved, you will be asked to sign a Facility Rental Agreement indicating that you are familiar and with and will comply with USSB’s health and safety procedures. You can find those procedures by clicking the button below. Thank you.

Read USSB’s Health & Safety Procedures

 

    Are you a Member of USSB?
    YesNo

    Select the Type of Event you are requesting? (Required)

    Have you already spoken with a USSB Staff Member about this Event? If so, please indicate that Staff Member's name.

    Your Group or Organization's Name (required)

    Is your Organization a Non-Profit Organization? (Please Note: To be eligible to receive our Non-Profit rates, you will need to submit a copy of your IRS Determination Letter.)
    YesNo

    Event Title (required)

    Brief Event Description (required)
    (This description only helps with the booking of your event and does NOT appear in any USSB Publications.)

    Contact First Name (required)

    Contact Last Name (required)

    Phone Number

    Your Email Address (required)

    Mailing Street Address (required)

    Mailing City (required)

    Mailing State (required)

    Mailing Zip (required)

    (Address used only to return your security deposit if you become a renter.)

    Who should we make out your Security Deposit Refund Check to?
    Me PersonallyThe Organization I'm Representing

    Will your event take place on a Single Day?
    yesno

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

    If your first Date choice is unavailable, please enter a Second Choice that would work for you? (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?

    Describe the Frequency of your Event: (e.g., 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)

    Are you charging an admission or requesting donations?
    YesNo

    If you answered YES, please provide details here:

    Alcohol Being Served?
    YesNo

    Food and/or Non-Alcoholic Beverages Being Served?
    YesNo

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

    Please Note that the only rooms that have Kitchen access are Parish Hall and Blake Lounge!

    About How Many People are you expecting will attend your event?

    If Chairs Needed, How Many?

    If Round Tables Needed (66"), How Many? (Additional charges will apply.)

    If Rectangular Tables Needed, How Many?

    Projector Needed?
    YesNo

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

    Sound System Needed?
    YesNo

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

    Kitchen Required?
    YesNo

    For an extra fee, would you like to have a USSB Event Assistant work at your event?

    (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.)
    YesNo

    If Yes, please explain:

    Comments, Questions, Setup Instructions or Special Requests

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