Application for rental of mobile facilities

Applicant

Name of the organiser (Association XY asbl)

Surname and first name (Jean Dupont)

Address (40, Grand-Rue)

Postal code (L-3394)

Locality (Roeser)

E-Mail (jean@dupont.lu)

Mobile phone (+352 621 123456)

Landline phone (+352 26 123456)

Bank

Account number IBAN (LU00 0000 0000 0000 0000)

Rental

Mobile Facility

Date and time beginning of the event (24.12.2017 08:00)

Date and time end of the event (26.12.2017 18:00)

Event (Celebration …)

Place of the event (School …)

Comment (It is planned to …)

ConsentI undertake to return the material in good condition.

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Contact & Opening Hours

Administration communale de Roeser

40, Grand-Rue

L-3394 Roeser

Monday: 1:00 p.m.-4:30 p.m.

Tuesday to Thursday: 8:00 a.m.-11:30 a.m. and 1:00 p.m.-4:30 p.m.

Friday: 7:00 a.m.-4:30 p.m. (non-stop)

Phone:

Technical hotline:

Hotline in the event of death (weekends and public holidays, from 9:00 a.m. to 11:30 a.m.):

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