Event Intake Application

Applicant's First Name:

Last Name

Email Address

Organization Name (If Applicable):

Address:

City

State:

Zip Code:

* Mobile Contact Number:

Alternate Phone Number:

* Occasion of Rental

* Date and Time of Event Start:

* Event Conclusion Time:

* Guest Count:

Second Day Event Start Time (if applicable):

Event Conclusion Time:

Guest Count:

Event Planner Name:

Event Planner Phone Number:

Event Planner Email:

NON-MEMBERS: Room Rental Options:

Ballroom Non-Member Rate - 1500 (Weekday)Youth Center Non-Member Rate – 750 (Weekday)Youth Center Non-Member Rate – 750 (Friday Night)Ballroom Non-Member Rate – 1500 (Friday Night)Ballroom - Non-Member - 1500 (Shabbos Day)Youth Center - Non-Member - 1500 (Shabbos Day)Graduation Main Sanctuary - 1800Main Sanctuary Basic Usage - 300

YILC MEMBERS: Room Rental Options:

Ballroom YILC MEMBER Rate - 1000 (Weekday)Youth Center YILC MEMBER Rate - 500 (Weekday)Youth Center YILC MEMBER Rate - 500 (Friday Night)Ballroom YILC MEMBER Rate - 1000 (Friday Night)Ballroom - YILC MEMBER - 1000 (Shabbos Day)Youth Center - YILC MEMBER - 1000 (Shabbos Day)Graduation Main Sanctuary - 1800Main Sanctuary Basic Usage - 300

Registered Non-Profits will have YILC Member Rate
Members must be in good standing. New Members less than a year
will be credited membership payments to the point of the membership rate.

Caterer to be used:

Phone Number:

Contact email:

* Equipment Rental:

Please Select OneNo, I do NOT require A/V EquipmentYes, I do require A/V Equipment and will choose from the next list of options.I need A/V equipment from YILC. (Please check all that apply) - $350 Fee for Setup and Usage

I require the use of a Sefer Torah for this event.

* Security Hours Required

(@$50 / hour: ** 4-Hour Minimum Security Charge - $75 / hour for corporate events)

Security should commence a minimum of 30 min before event and last throughout event.

Total Due:

* By Checking each box, I agree:

I will only use food and/or catering services at Young Israel of Lawrence Cedarhurst (YILC) certified Kosher by the Va'ad of the 5 Towns, or any recognized National Orthodox certification, and I will ensure food arrives sealed to the premises.All caterers must be approved by YILC at least one week prior to event and I will ensure they provide a Certificate of Insurance indemnifying YILC and all it's directors, and they have a liquor license (if serving liquor).(If not using a full-service caterer): I will hire a minimum of 2 waitstaff responsible for setup and cleanup for private delivery. I will make sure they will be responsible for cleaning up, and removing garbage to the outside dumpster following event.I will provide setup plans for tables and chairs for 'non catered events' to the office a minimum of 2 business days prior to the event.Cleanup is ultimately the responsibility of the renter. If the caterer or the hired staff serving do not ulitmately restore the room to the original condition, a cleaning fee of $350 will be charged to the renter.I understand this is an application and does not constitute a contract.

PLEASE NOTE: Members need to log into their account to Bill-to-Account and pre-populate forms ^^

Event Intake Application