Facility Request

Group or Ministry REQUIRED Please fill out this field. Please enter valid data.

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Email REQUIRED Please fill out this field. Please enter an email address.

Mobile Number REQUIRED Please fill out this field. Please enter a phone number.

Date Requested REQUIRED Please fill out this field. Please enter valid data.

Time of Event REQUIRED Please fill out this field. Please enter valid data.

Type of Event REQUIRED Please fill out this field. Please enter valid data.

Set-up Time REQUIRED Please fill out this field. Please enter valid data.

Clean up Time REQUIRED

Each Group is responsible for their own set up and clean up.

Please fill out this field. Please enter valid data.

Parish Life Center Request St. John Vianney St. Clare St. Elizabeth St. Benedict St. Fancis

Do you need an access Code REQUIRED

These codes will allow you to enter the facility

Please fill out this field.

You must meet with Facility Coordinator to complete and sign request form and to discuss event details and fees (if applicable).

I hereby certify that the person/organization named above shall assume responsibility for any damage sustained to the facility premises, furniture, or equipment, resulting from the use of the facilities by the person using facilities and shall “Hold Harmless” St. Simon the Apostle from liability.

I Agree to these terms Please select this field.

Saint Simon the Apostle

A Community of Prayer, Praise and Worship

Facility Request

Facility Request Information

Facility Request Form