APPLICATION FOR USE OF FACILITIES


Welcome to the Washington District of Columbia Jewish Community Center. We look forward to ... 1529 16TH Street NW, Washington, DC 20036. 202-518-9400 ...

APPLICATION FOR USE OF FACILITIES Welcome to the Washington District of Columbia Jewish Community Center. We look forward to working with you to make this program a success for all involved. Name of Program _____________________________________________________ Date of Program _________________________ Name of Organization or Individual: _____________________________________________________________________________ Street address, City and State: ___________________________________________________________________________________ _______________________________________________________________________________________________________________ Contact Person: _______________________________________ Phone Number __________________________________________ Contact Person: _______________________________________ Phone Number __________________________________________ Day of event contact and phone (if different from above): __________________________________________________________ Fax number_____________________________________ E-mail address (optional ________________________________________ Day of Week: ___________________________________________________________________________________________________ Description of program: _________________________________________________________________________________________ Start Time: _________________________________

End Time: _________________________________

Set Up Time: _________________________________

Start Time: _________________________________

End Time: _________________________________

Set Up Time: _________________________________

Start Time: _________________________________

End Time: _________________________________

Set Up Time: _________________________________

Room Requested: _______________________________________________________ Approximate Attendance: _______________ Room Requested: _______________________________________________________ Approximate Attendance: _______________ Room Requested: _______________________________________________________ Approximate Attendance: _______________ Please list only one event per sheet. (You can list an event with multiple room usage) Name of Caterer (must be kosher; mashgiach required): ____________________________________________________________ Please indicate if you are: • A member agency of the Jewish Community Council or United Jewish Appeals Federation - A • A non-profit agency, not affiliated with above mentioned organizations or a DCJCC member renting for private use -B • A non-DCJCC member renting the facility for private use and for profit organizations -C

Washington District of Columbia Jewish Community Center 1529 16TH Street NW, Washington, DC 20036 202-518-9400 x3265 • Fax 202-518-9420

If this contract is approved, the conditions and regulations stated in this agreement, as well as, any attached usage guidelines (if additional forms apply) will be observed, and the person named as contact person above will assume all responsibility for honoring agreement, damages, loss, or other liability arising from the use of the facilities. Programs are not confirmed until deposit is received. Projectionists must be hired from the projectionists union at (202) 526-1944. *Please sign and return this page, along with a $200.00 Non-refundable deposit within in 7 days to guarantee your space reservation. If deposit is not received in 7 days space may not be held and new arrangements may have to be made. Return this agreement to the attention of: wanda chichester. **If your event is to take place within one month of reservation full payment is due upon receipt of agreement. If payment is not received within 10 days of the reservation we reserve the right to release said space. There is no refund on reserved space not used or cancelled within 10 days of a scheduled event. Authorized Representative Co Sponsorship _________________________________________________ Date ________________ Authorized Representative of Washington DC JCC ___________________________________________ Date ________________ Signature of this contract confirms acceptance of the terms stated in this agreement and any attached usage guidelines or policies that may apply

To Be Completed By the Washington DCJCC Only Total Usage Fee Per Space _______________________________________________________________________________________ Total Set-Up Fee ________________________________________________________________________________________________ Special Needs Fee ______________________________________________________________________________________________ Deposit Paid _________________________________________________________ Date _____________________________________ Balance Due _____________________________ Date Due ______________________ Date Paid _____________________________ Please Complete This Section For All Facility Usage

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Application For Hire Of Facilities. Submission of this form does not guarentee the booking, please wait for written confirmation. Please complete this form.

Welcome to the Washington District of Columbia Jewish Community Center. We look forward to working with you to make this program a success for all involved.

Members: I understand that a refundable cleaning/damage deposit of $100 is required in addition to the nonrefundable use fee(s) outlined above, paid upon submission of request. Community Groups, Non-members, Government Groups, and For-profit Groups:

SPACE REQUESTED: Auditorium. Large Gym. Baseball/Softball Fields. Lecture Room. Cafeteria—North Side. LRC. Cafeteria—South Side. Small Gym. Classroom/s. Staff Lunch Room. Room: ...