ACACIA LODGE NO. 20 F&AM
20 THOMPSON AVE. DOVER. NJ 0780
PHONE 973-328-9768
HALL RENTAL

NAME

ADDRESS_______________________________________________

CITY ___________________  STATE_____________ ZIP_______

PHONE___________________ CELL___________________ EMAIL

RENTAL DATE____________________ TYPE OF PARTY_______________________

TIME OF PARTY FROM________________ TO ____________________

NUMBER ATTENDING________ TABLES - ROUND (SEAT 8) or RECTANGULAR (SEAT 10)
DONATIONS

FOUR HOURS MINIMUM $ 375.00

EACH ADDITIONAL HOUR $100.00

CUSTODIANS I BARTENDERS - $80.00 EACH FOR FOUR HOURS TWO REQUIRED FOR PARTIES 100 OR LESS

THREE REQUIRED FOR PARTIES OVER 130

$ 20.00 EACH FOR EVERY ADDITIONAL HOUR KITCHEN FACILITIES $100.00

31,i0

Silitt3 FEE FOR DISPOSAL OF EACH BAG OF GARBAGE

GENERATED BY THE PARTY AND NOT REMOVED

$100.00 CLEANUP FEE IF APPLICABLE

TOTAL

DEPOSIT $200.00 (REQUIRED TO RESERVE RENTAL DATE)


DEPOSIT AMOUNT PAID RENTER'S SIGNATURE

BALANCE OWED MEMBER'S SIGNATURE



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