Charitable Purpose Reservation Form

This form is used by an Odd Fellow member to sponsor an organization or charitable purpose for use of the Lodge hall or event space.

The sponsoring member agrees to be present at the event and to follow all security, set-up, and clean-up protocols as specified in the Contract for Use of the Odd Fellows Hall and Event Space.

Under No Circumstances may the Lodge Room or Member Lounge be used or reserved for an event.

Sponsoring Member Information

Member Name *

Date of Submission

Email Address *

Phone Number

Organization Being Sponsored

Organization Name *

Non-Profit Status

Yes No Unknown

Organization Contact Person

Organization Phone

Organization Email

Is the organization aware of this sponsorship request?

Yes No Not Applicable

Space Required

Which Spaces Are Required? (Select all that apply)

South Hall (Ballroom) North Hall Kitchen (requires North Hall reservation)

Event Information

Event Date *

Start Time *

End Time *

Event Description *

Sponsoring Member Agreement

By providing your name below, you — as the sponsoring Odd Fellow — agree to abide by all terms of the Contract for Use of the Odd Fellows Hall and Event Space; to be present at the event; and to follow all security and clean-up protocols.

Member Name (typed signature) *

Date

A physical signature will be required on the printed copy presented at the Lodge meeting.

For Officer Use Only

The fields below are completed by lodge officers only.

Financial Secretary — confirms member meets requirements

Financial Secretary Name

Date

Secretary

Secretary Name

Date

Secretary Financial Record

To be completed by Secretary only after approval.

Proceeds Received?

Yes No

Amount Received ($)

Correspondence Sent?

Yes No

Item	Cost	Donated Amount	Amount Due
Hall Rental	$	$	$
Security Deposit	$	N/A	$
Event Staff ( hrs @ $50/hr)	$	$	$
Cleaning Fee ( hrs @ $50/hr)	$	$	$
	$	$	$

Deposit on File?

Yes No

Date Available & Approved?

Yes No

Contract Signed?

Yes No

Business Manager — Signature of Confirmation

Business Manager Name

Review Your Submission

Submitting emails this form to the Lodge Secretary. You may also print and bring this form to your meeting.

Member Sponsored Charitable PurposeReservation Form

Form Submitted

Member Sponsored Charitable Purpose
Reservation Form