Facility Request Form

Please choose YOUR membership type, or your groups membership type, in relation to Gashland EPC*
- Member
- Non-Member
- Non-Profit Organization
Contact Information
Group/Organization Name
Your First & Last Name*
First Last
Email*
Contact Phone 1*
Best phone number to reach you on the day of your event.
Contact Phone 2
Mailing Address*
Street Address City State ZIP Code
Please provide the name and contact information for the person responsible during the actual event.
Name (If Different From Above)
First Last
Best Day of Contact Phone Number (If Different From Above)

Event Times & Dates
Desired Date of Event or Meeting*
Month
Day
Year
Desired Time to Enter Building for Set Up*

: Hours

Minutes

AM/PM
Time Event Begins*

: Hours

Minutes

AM/PM
Time Event Ends*

: Hours

Minutes

AM/PM
Time You Will Be Exiting Building (Allow for Yourself Plenty of Clean Up Time from the Time Your Event Ends.)*

: Hours

Minutes

AM/PM
Total the hours you will be in the building from Set Up to Clean Up*
This is the number of hours you will be charged for when booking a room. Please enter this number into the Number of Hours Requested box under each room you request use of.
Event Details
Estimated Number of Individuals Attending Event/Group Meeting*
Please enter a number from 1 to 350.
Fire Dept. Occupancy Load Disclaimer While the fire department requires us to display the following occupancy loads: Sanctuary-275; Chapel-8; Holy Grounds Cafe-80; Fellowship Hall-288; Ministry Center- 932; please know that we are only able to accommodate the seating capabilities listed earlier in the form.
Event Details*
Please provide us with some event details. How many tables/chairs you will need, if you are seating banquet style or theatre, If you will be serving food, doing arts & crafts, setting up props, types of activities you will be doing, etc.

Contact Information