Request for the Use of the Moebius Nature Center

________________________________________________________________ (Name of Individual or Organization) Please indicate if you are a MNC Member

________________________________________________________________

(Purpose for which meeting or activity is to be held)

________________ ____________________ __________________

(Date or Dates) (Hours of Use) (# Attending)

Will food be served? Y - N

________________________________________________________________

(Name of person in charge and their Address)

_________________________ __________________________________

(Phone Number) (Email Address)

If you have any questions please contact Kim Pease at 330-562-2592 or email Kim@moebiusnaturecenter.org.

Return completed form to:

Moebius Nature Center

Attn: Kim Pease

P.O. Box 595

Aurora, Oh 44202