Grace Episcopal Church

							                  Grace Episcopal Church, Wheatland CA
                               Pioneer Hall

                                Check one:

                          Rental
        Private Rental        Non-Profit Rental
                              
                          Donation
        Memorial Reception    Church member use

                          Other: describe below
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Renter’s name:


Date of rental:


Check number Deposit & Amount:                       $

Check number Rental & Amount:                        $


OR

Cash amount: $



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Official use only:
 Deposit date:
 Quicken entered date: