INSTRUCTIONS: Print this page, complete all sections, and mail or fax the completed form
Moolah Shrine Center   12545 Fee Fee Road
St. Louis, MO 63146
Fax: 314-434-5393
www.moolah.org

MOOLAH SHRINERS 2004

SHRINE CENTER RESERVATION

Date of Request ______________________________
Name of Unit/Committee/Club ______________________________
Name of event ______________________________
Date requested             (1st) _______    (2) _______    (3) ______
Moolah room or facility requested OR ______________________________
Outside facility or location ______________________________
Approximate number of people attending ______________________________
We will have a joint event with to increase our purchasing/party power
______________________________
Your name ______________________________
E-Mail ______________________________
Mailing address ______________________________
CSZ ______________________________
Phone # ______________________________
Fax# ______________________________
NOTE: Once your date is approved, please forward a completed Event Planning Guide form indicating your set up requirements to the Moolah Shrine Center office.
Approved: ______________________________
Approval Date ______________________________