Property Reservations Application Regular Use Meeting Form

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Property Reservations Application
Regular Use Meeting Form
Registrar Department 9525 Monte Vista Ave. Montclair, CA 91763
T (626) 677-2366 F (909) 624-7928
Complete and return all forms with applicable fees to the Registrar Department Attn: Property Registrar
Name: ____________________________________________________________
Troop Number: ________________
Name of Organization (If Non Girl-Scout):________________________________________________________________
Meeting Information:
Property Requested: __________________________________________ Room (If Applicable):_______________________
st
rd
nd
th
st
nd
rd
th
Meetings to be held:
___ Weekly
___ Bi-Weekly (___1
/3
or ___2
/4
)
___ Monthly (___1
___ 2
___ 3
___ 4
)
st
Day of the Week Requested: 1
Choice___________________________ From :_________(am/pm) To:_________(am/pm)
nd
2
Choice__________________________ From :__________(am/pm) To:_________(am/pm)
Date Meetings are to: Begin: ________________________ End: ________________________
Would you like to reserve a Storage Cubby?* (Chino, Covina, & Montrose Only) Yes: ________ No: ________
* Storage Cubbies at Chino, Montrose, & Covina are available to Service Units and Troops for the Regular Use Year, September-June
Troop/Group Information:
Girl Scout Level:
____ Daisy
____Brownie
____Junior
____Cadette
____Senior
____Ambassador
Reason for Meeting: ____Troop Meeting ____Service Unit Meeting ____Training
____Other___________________
Are all attending Girl Scout Members? ___ Yes ___ No
(If No, please refer to Insurance Requirements and submit required paperwork)
Expected Attendance: Adult________________________ Children (Under 18 Years): __________________________
Responsible Person: Name: ________________________________________________________________________
Address: ______________________________________________________________________
City and Zip Code: ______________________________________________________________
Phone Number: Home (____) ____________________ Cell: (____) _______________________
Email Address: _________________________________________________________________
As the person responsible for the meeting, I have read all policies and procedures and recognize the responsibility that I have to see that
care and cleanliness of the building is maintained. When utilizing council properties, please remember to be flexible and exercise the
cooperative spirit of the Girl Scouts.
Signature: _______________________________________________________________ Date: ____________________________
Note: Reservations are made on a First-Come, First-Served basis and must be complete with fees. Girl Scouts of Greater Los Angeles reserves
the right to refuse use of any facility, reschedule, or cancel any reservation at any time. Should your regular meeting date be canceled due to a
Council Meeting or Training, you will be notified in advance.
Payment Information:
Credit Card Type: Visa:
MasterCard:
Discover:
Amex:
Site Fee Amt: _________________
Card #: ________________________________________________
Exp Date: _____________
C V V #:______________
Security Dep. Amt: _____________
Signature: ____________________________________________
For Office Use Only:
Key Mailed:_______________
Amt. Deposited:_______________
Confirmation Sent:_______________
Access Code Sent:______________
Fee Returned:_______________
Fee Retained: _______________
03/16

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