Hall Rental Request Form

Name

Co-Applicant Name

E-mail Address

Phone Number

Rental and Use Information

Dates Requested

From: Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 2003 2004 2005 2006 2007 2008 2009 2010 2011
To: Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 2003 2004 2005 2006 2007 2008 2009 2010 2011

Hours of Use

From: 1:00AM 2:00AM 3:00AM 4:00AM 5:00AM 6:00AM 7:00AM 8:00AM 9:00AM 10:00AM 11:00AM 12:00PM 1:00PM 2:00PM 3:00PM 4:00PM 5:00PM 6:00PM 7:00PM 8:00PM 9:00PM 10:00PM 11:00PM 12:00AM
To: 1:00AM 2:00AM 3:00AM 4:00AM 5:00AM 6:00AM 7:00AM 8:00AM 9:00AM 10:00AM 11:00AM 12:00PM 1:00PM 2:00PM 3:00PM 4:00PM 5:00PM 6:00PM 7:00PM 8:00PM 9:00PM 10:00PM 11:00PM 12:00AM

Purpose of use: Wedding Business Meeting Social Affair Other

Expected Attendance:

Special Requests

ICLF Requirements

Insurance Verification (provide copy)

Security Staff Provisions (1 security guard per 100 attendees minimum)

Security Company:
Contact Name: First M.I. Last
Primary Phone: Secondary Phone:

Liquor Service yes no

Special Requests for Liquor Services:

Estimate of Costs and Deposit Requirements

Estimated Total Cost per Rental Worksheet:
Reservation Deposite (minimum $500.00, or 25% of the total estimated cost, whichever is greater):

Upon submission of this form, you certify the above to be true. You will be contacted by a representative of The Irish Cultural Center after reciept. No reservation is made until the deposite is paid in full. We reserve the right to deny any request, for any reason.