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The Club, Unit or Other organization (shown below) requests approval of the following schedule for the utilization
of the Ansar Shrine Center for the dates and times indicated. It is understood that if conflicting requests are
received by the Recorder on the same date, conflicts will be referred to the requestor(s) for resolution.
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THE REQUESTOR
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NOTE - First select from the "drop down" list directly below by clicking on the arrow button located
at the right end of the box then highlighting your Unit or Club by clicking on it. Then Press [TAB]
Key to lock-in your choice. (If you have a scrolling wheel on your mouse and do not lock your
club/unit selection, the Internet Browser thinks you are still selecting and will continue scrolling the
drop-down list.)
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Unit or Club:
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(If Not In List, Enter Here)
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Submitted By:
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Title:
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REQUESTED FACILITIES
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Date(s) Requested:
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Auditorium
1st Floor Kitchen
Lower Level Dining Room
Lower Level Kitchen
2nd Fllor Foyer
TV Room
Pool Room
Other (Specify Below)
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Rooms Requested:
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Check All That Are Needed
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SETUP
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Set-up date (if different than event date):
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Set-up Start Time:
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End Time:
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Special Requirements:
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THE ACTIVITY
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Activity Type:
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(Meeting, Party, Dinner, etc)**
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Approx. Number Of Persons:
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Event Start Time:
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Event End Time:
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** Any organization utilizing Ansar Center for a fundraising event must complete an ACTIVITY
REQUEST form, a REQUEST FOR USE form, complete a FINANCIAL REPORT form, submit
the ASSESSMENT as follows: According to Article IV of the Rules and Regulations governing
the use of the Ansar Center, user organizations will pay to the Ansar Shrine Building, Inc. a fee
of 5% of the GROSS RECEIPTS of their fundraising events.
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