In Duplicate uof.doc
WESLEY METHODIST CHURCH
136 Jalan Burma
10050 Penang
Date Hand In [ ]APPLICATION FORM
USE OF FACILITIES (UOF)
MYC - Ground Floor MYC -1st Floor
[ ]Church Sanctuary [ ] Church Van[ ] Matthew Room [ ] Isaiah Room [ ] Aldersgate Foyer [ ] Parking
[ ] Mark Room [ ] Jeremiah Room [ ] Hannah Hall [ ] Video Player
[ ] Luke Room [ ] Ezekiel Room [ ] Susannah Room [ ] LCD Projector
[ ] John Room [ ] Daniel Room [ ] Glad Tidings [ ] P.A. System
[ ] Kitchen [ ] Joshua Room [ ] Fellowship Corner [ ] OHP
[ ] Samuel Room [ ] Badminton Court [ ] Others (specify)
_________________
MYC - 2nd Floor
[ ] Wesley Hall
[ ] Kitchen
Name : ................................................................. Organisation :..............................................................
(if applicable)
I .C. No: ................................................................. Tel Contact:................................ Office Tel :..............................Home:
Address:.......................................................................................................................................................
Date(s) applied for:................................................... ... Time: From ..............To...........................
Purpose of Use:......................................................................................... No. of People attending:.........................
Serving of: Food [ ] Drinks [ ] Tick in box if YES
Security Deposit RM ____________
( refundable only if no contravention of general guidelines of usage of facilities and no damage to
Properties ). And hereby enclosed RM_______________ as contribution.
I / We hereby understand and agree to observe all prevailing general guidelines pertaining to the use of the above facilities.
Signature:__________________ Date__________________
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For Office Use only Receipt No: Copy to Mr. Bala: Remark: Notice Board : Approval :
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