Village Grande at English Mill Homeowners Association 
                        FACILITY RESERVATION REQUEST FORM 
                                     (Return by Email, fax or place in Mailbox outside Site Manager’s Office) 
        Name: ____________________________________________________                 Phone No.: _________________ 
        Address: __________________________________________________                Email: _____________________ 
        Organization Sponsoring Event: ________________________________            Room Requested: ____________ 
        Description of Event: ___________________________________________________________________________ 
        Date of Event: ______________        Start Time: ______________            Compl. Time: ______________ 
        Set up Time Requested:  Date: ______________        Time: _____________ 
        (Note: Set up time should be flexible to accommodate other needs for the facility) 
        Comments: 
        ______________________________________________________________________________________________ 
         
        Please keep a copy of this form for your records.  You will be notified on the disposition of this request.  
         
        (For use of HOA only) 
        Date Received: ____________  By: ______________     Status: __________ 
        Reservation Date & Time: ______________________     Setup Date &Time: ____________________________   
        Action Taken: 
        __________________________________________________________________________________________________ 
        __________________________________________________________________________________________________ 
        Rev. 12-2-13                                                                                                             Form 106