GNS Community Room Application — Great Northern Services

Please read the Policies and Eligibility and Application Process information on this website before completing the online application below. Once your application is reviewed, GNS Public Relations & Fundraising Manager Nichole Smith will contact you to confirm your eligibility, review the facility availability, and discuss any fees that may apply. If you do not hear from us within 3 days after completion of your application please call (530) 938-4115 extension 115.

Organization*
Contact Name*
First Last
Title
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Email*
Preferred Method of Contact*
Website
Classification of your organization*
Other, please describe
501(c)(3) Tax ID Number
What is the purpose of your event?*
Other, please describe
Approximate number of participants*
Need access to:
- Kitchenette
- Audio-visual
Will you need access to:
- Kitchenette
- Audiovisual
Reservation Date – First Choice*
Reservation Date – Second Choice*
Meeting Start Time*

: Hours

Minutes
Meeting End Time*

: Hours

Minutes
I have read the "Meeting Planner, Policies and Facility Capabilities" as well as the "Eligibility and Application Process" documents.*
- YES
- NO
I agree to the statement below.*
- Yes
- No
I hold Great Northern Services harmless from any liability for loss, damage or injury associated with this event. I agree to indemnify Great Northern Services for any claims made for loss, damage or injury associated with this event.
Privacy Disclosure*
- I consent to having this website store my submitted information so they can respond to my request.

Location and Mailing Address

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