Rental Payment Form - Unitarian Universalist Church in Reston

Directions: Please use this form to submit a rental payment to the Unitarian Universalist Church in Reston (UUCR) after your rental dates have been confirmed by the church Office Director. Do not submit a payment for a rental date that has not been confirmed.

Note: Security deposits must be paid by check, made out to UUCR.

Name

This address will receive a confirmation email

Phone

Confirmed Rental Date

Acknowledgement

I have received a rental confirmation for the above date from the UUCR Office Director.

Payment Amount

Comments (Optional)

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Please fill out this form and click submit.

Rental Payment Form - Unitarian Universalist Church in Reston

Description

Please Fix the Following