Winter 2009

Please complete the following application, sign it, and return it along with a check in
the proper amount made payable to “Village of Michiana”.  Once this application
is approved by the Village Council, your lease will be entered onto the calendar. 
The Village Council meets on the second Monday of each month.

Private Party                                      Not-For-Profit Organization

Name:  _________________________________________________________

Local Address:  ______________________________________________________________

Date of Party:  ______________________________

Reservation Time:  ______________   Termination Time:  ___________________

Type of Party:  _________________    Deposit Amount:  ___________________

Rental Fee:     $250 rental fee / $300 deposit*

(*deposit shall be refunded if room returned to original condition)

The Community Room will be available in a ready-to-use condition ______ hours
prior to reservation time.  You must obtain prior approval for all decorations.

You must contact the Michiana Village Police Department (269.469.1884)
to arrange for access to the Community Room. 
The Village Clerk will furnish the Police Department with copies of all rentals. 
The applicant acknowledges and agrees to assume full responsibility for the
premises during the reservation period and shall assume responsibility to insure
the safety of guests.

The applicant agrees that in reference to a not-for-profit party,
a special event one-day liquor license must be obtained from the
Michigan Liquor Control Commission.

Note:  You are responsible for cleaning the hall after its use.  In the event
you fail to return the hall in clean condition, the Village may have it cleaned
and charge the expense to you.

 __________________________________         ________________________

Council Approval Date              Deposit Refund               Check # and Date