YOUR PERSONAL DETAILS (optional information can be useful in emergency situations!)
1. Your Name (essential)
2. How would you prefer to be contacted?
By any of my given options By my personal email BY my home landline telephone By my mobile telephone By my professional email By my institution's telephone
3. Your home landline telephone (optional)
4. Your mobile telephone (optional)
5. Your personal email (optional)
6. YOUR GROUP'S DETAILS
7. Type of Group
Faith/Philosophical Group Inter-Faith Group Informal Discussion Group Registered Charity Church Group Local Club or Society Young People's Group Unfunded Group Other (please specify below)
7a. Details: other type of group
8. Name of Group
9. Your position in Group
10a. Contact Address - Building Name or Number
10b. Street
10c. Village / District
10d. Town
10e. County
10f. Post Code
10g. Telephone (day time)
10h. Your professional email (essential)
YOUR BOOKING DETAILS
11. Type of Booking
A One Off Weekly Monthly Qarterly Other (please specify below)
12. Which day of the week do you want to meet?
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
13. What time of day do you wish to meet?
Morning Afternoon Evening
14. Which Date do you wish to book?
15. At what time do you plan to arrive?
16. At what time do you plan to depart?
17. How many people are you expecting to come?
18. Who will be 'your responsible person'?
19. Do you have any specific requirements?
YOUR TREASURER'S DETAILSIf your booking is accepted, your group will be invoice on a quarterly basis for the Service Charge
20. Who should we Invoice for the Service Charge?
Myself The person named below
21. Office held by person to be invoiced?
Treasurer Chairman Secretary Other (please specify below)
22. Office held by person to be invoiced?
23. Name of Officer
24. Officer's Address - Building Name or Number
25. Street
26. Village / District
27. Town
28. County
29. Post Code
30. Telephone (day time)
31. Officer's email
APPLICATION VALIDATION
32. Name of Applicant
32. Date of Application
Check your entries and when you are sure they are correct Please click on 'Submit Form'