Facility Application

InPower Institute is an empowerment, health and wellness center that advances wholeness and well-
being at every level of the human experience. The Institute helps individuals and groups exercise
their power to create loving, healthy lives, families, communities and a vibrant, sustainable world.
InPower faculty and affiliates offer programs, workshops and services in five core areas: 1)
inner/spiritual development, 2) personal growth and mastery, 3) family health and wellness, 4)
community empowerment and connection, and 5) planetary well-being. If you are interested in
conducting trainings, providing services, or hosting events at InPower in any of these areas, please
complete this form or contact Rebeccah Bennett at 314-210-8123 or
rbennett@emergingwisdomllc.com .

Background Information:

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First Name Last Name

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Street City State Zip

(______)__________________ (______)_______________________________________________________
Home Cell Email

Brief description of Event/ Program/ Service/ Workshop you want to offer:

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

Dates / times you are requesting facility space: (Ex: My class will meet each Monday during the month
of May from 4-6 p.m.)

1st Choice:_________________________________________________________________________________

2nd Choice:_________________________________________________________________________________

3rd Choice:_________________________________________________________________________________

InPower Institute • 5400 Nottingham Ave., St. Louis, MO 63109 • A Division of Emerging Wisdom LLC
How did you hear about us?

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Emergency Contacts:
Please provide contact information for one person that can be notified in case of emergency.

____________________________________________________________________________________________
First Name Last Name Relation to you

____________________________________________________________________________________________
Street City State Zip

(_____)__________________ (______)________________
Home Cell

Facility Amenities & Fees:

 Audio Visual Equipment: The following are available upon request:
o DVD: Fee = $10
o LCD Projector: Fee = $30
o Projector Screen: Fee = $10
o Television (32” LCD/HDTV) = $30
 Large Meeting Room: 1,900 square feet with accompanying bathroom. Fee = $30/hour
 Small Meeting Room: 225 square feet. Fee = $15/hour
 Seating: 30 folding chairs available. No fee
 Tables: 2 rectangular folding tables available. No fee
 Web-based Promotions: Institute will promote event/ workshop/ program on its website if
desired. Must provide event/ program/ workshop description, picture (if available), contact
information (telephone or email), participation/ registration fees, date and time, link to your
website (if available). Information must be given to facility staff at least 4 weeks before event.
No fee

Rules For Renting & Using Facility:

 Deposit: 20% due when facility use agreement signed. Balance of rental fees due 7 days before
event/ workshop/ program
 Cancellation: If cancellation occurs 7 to 14 days before event/ workshop/ program, deposit is
retained. If cancellation occurs fewer than 7 days before event/ workshop/ program, full rental
fee is retained
 Capacity: Maximum number of people in facility may not exceed 100
 Children: Children must be accompanied by parents or supervised by an adult associated with
event/ workshop/ program at all times while in facility
 Facility Condition: Facility should be left in same condition as it was found. Clean up after
event/ workshop/ program. Basic cleaning supplies located in bathroom closet in large meeting
room
 Food & Beverages: Food and drinks not provided. Approval for outside food and beverages
must be obtained from facility staff
 Hours of Operation: Facility available for use between 7am and 12 midnight
 Noise: Keep noise to a reasonable level. Noise should not be able to be heard from outside /
across street. Be respectful of tenants living in residential units above facility
 Right Fit: Institute reserves the right to select programs that are appropriate for facility size and
purpose

InPower Institute • 5400 Nottingham Ave., St. Louis, MO 63109 • A Division of Emerging Wisdom LLC