Facility Use Application

We are grateful for your interest in using our facility. Please complete the following form. Someone will be in touch shortly after submission.

Please note that proof of liability insurance may be requested before approval of an event.

Once your application is approved, fees may be paid by check, payable to Our Saviour's Lutheran Church. The current fee schedule may be viewed here.

Today's date

Organization name

Primary Contact first name

Primary Contact last name

Day Phone

Mobile Phone

Fax

Email

What is your organization's (or event's) primary mission/purpose?

Date and time requested

Month

Day

Year

Time

HoursMinutes

Frequency

One Time Use

Weekly

Monthly

Other

What day of the week do you hope to reserve (for recurring events)? Please choose your first preference, and note second choice in 'general information' section if applicable.

General information (Please describe the type of event you are planning).

Anticipated total number of participants.

Of the total, how many participants under the age of 18 do you anticipate?

Will tickets be sold or admission be collected for your event?

Yes

No

If yes, what are the admission fees and how will the net proceeds of this event be used?

Will food and/or drink be consumed during your event?

Yes

No

If yes, please describe the type of food (e.g. packaged snacks, catered meal, etc) and if you hope to use the kitchen.

Will alcohol be consumed? Please note that outside groups will need permission to bring alcohol on premises.

Yes

No

If yes, please describe type and amount.

Is your group a registered non-profit (501(c)(3))?

Yes

No

If yes, please provide your Nonprofit Tax ID number.

If you need tables and chairs, please indicate approximately how many.

Please use this space to indicate any special needs or requests that have not already been addressed.

Fellowship Hall

*Note: as of May 8, 2024, Room 3 and the Dorcas Room are unavailable for use

Main Building - Basement

Main Building - Main Floor

Our Saviour's Lutheran Church

Norge, VA

Facility Use Application

Fellowship Hall

*Note: as of May 8, 2024, Room 3 and the Dorcas Room are unavailable for use

Main Building - Basement

Main Building - Main Floor

Main Building - Upstairs

Facility Use Application

Fellowship Hall *Note: as of May 8, 2024, Room 3 and the Dorcas Room are unavailable for use

Main Building - Basement

Main Building - Main Floor

Main Building - Upstairs

Fellowship Hall

*Note: as of May 8, 2024, Room 3 and the Dorcas Room are unavailable for use