In the Matter of Application 24729 of NORTHERN CALIFORNIA 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the Licensor Information section. Enter the Church/School Name, Phone, Contact Person Name, E-Mail, Address, and County. Ensure all fields are completed accurately.
3. Next, provide details for two representatives from your organization. Include their names and titles in the designated fields.
4. In the Licensee Information section, input the Legal Organization Name, Phone, Contact Person Name, E-Mail, and Correspondence Address. Remember to attach proof of 501(c)(3) status and insurance.
5. Fill in the Agreement Information by specifying contract dates (from and to), financial information including amount and frequency of use (month/week/use), room(s) to be used, days of use, and time of day for use.
6. Complete any additional instructions as necessary. Don’t forget to include a copy of board meeting minutes approving shared use.
7. Finally, gather all required documents including signatures from both Licensor and Licensee before submitting via email or fax as instructed.

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