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Merfish Teen Center Rental Request Form

Name of Organization
Contact Name
Contact Phone
Address
Address2
City
State
Zip
Contact Email
Contact Fax
 
Type of Program
 Bar/Bat Mitzvah
 Private Party
 Seminar
 Other
Other (please specify)
 
Date/Time
Alternate Date/Time
Alternate Date/Time
 
Equipment Needs (refer to Fee Schedule for additional costs)
Comments