Required fields are marked with asterisks (*)

Facility Booking Rental Request Form Fire Hall

This application form will be submitted electronically to rox-anne@southstormont.ca and you will receive a copy by email. Please know this is a rental request form and does not guarantee or secure the booking. Your request will be reviewed and you will be advised as to the status of your request.

Applicant Contact Information

First Name

Last Name

Are you making this request on behalf of an organization?

Yes

Status

Not for Profit

Profit

Address ( Number & Street Name )

City/Town

Postal Code

Telephone

Email Address

Event Information:

Provide below description of the activities that will take place during your event.

Event Description: (i.e. Bridal Shower Event, Program, Small Family Event, etc.)

Number of Attendees:

Date Choices

Event Date: First Choice

Event Start Time:

Event End Time:

Event Date:Second Choice

Event Start Time:

Event End Time:

Personal information contained on this form is collected under the Municipal Freedom of Information and Protection of Privacy Act and will be used to respond to your request. Questions about this collection should be directed to the Director of Corporate Services at 613-534-8889 ext.201.