St. Mary the Virgin Church

Leigh Woods

Hirer………………………………………………………………………………

Address……………………………………………………………………………

…………………………………………………………………………………….

Telephone No:……………………………………………………………………

Date of Hiring…………………Time of Hiring from……………….to………….

Hiring:

1 Church £50.00/4 hours Yes No

2 Choir Vestry £5.00/hour Yes No

3 Heating: Church £20 Yes No

Vestry £10 Yes No

4. Kitchen: inc. use of oven £5.00 Yes No

5. PA/loop system £5.00 Yes No

6. Electric piano £5.00 Yes No

Total Charge:…………………………

Keys: Collect………………………………………………………………………

Return…………………………………………………………………………….

Cheques: made out to ‘St.Mary’s, Leigh Woods PCC’

Contact: Warden Maurice Clothier, Tel: 0117 9733846

17 Foye House, Bridge Road, Leigh Woods, BS8 3PE

or Alan Shellard Tel: 0117 9741494

Booking confirmed………………………………………Date………………….

Please sign and return copy………………………………Date………………….