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* 1. Name of Organisation

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* 2. Charity Number (if applicable)

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* 3. Contact Name

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* 4. Address (for hire agreement)

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* 5. Email

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* 6. Telephone

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* 7. Please indicate which best describes you:

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* 8. Purpose of hiring space

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* 9. Date from

Date / Time

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* 10. Date to 

Date / Time

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* 11. Duration:

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* 12. Evening?

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* 13. Space required

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* 14. Number of attendees (approx)

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* 15. Other requirements/ additional hires

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