Church Event Facility Request

Request Date

Organization Name:

Requester Name:

Phone:

Email:

Building, Room, or Specific Location

When did you first notice the issue?

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Type of Issue

Select:

Heating or air conditioning

Plumbing or restooom

Electrical or lighting

Door, lock, or building access

Cleaning

Custodial

Equipment or furniture

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How does the issue affect use of the space?

Select

The space remains usable

Some activities are affected

Space cannot be used

Describe the Issue

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Photo(s) of the Issue:

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Optional; you may email photos to facilityusage@boulevardbaptist.com

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