FACILITIES USE REQUEST FORM

Facilities Use Request Form

Contact Person

Phone

Mailing Address

Estimated # of Adults Attending

Estimated # of Youth Attending

Event Title

Member (Yes or No)

Event Start Date

Organization

Event Description/Purpose

Event End Date

Recurring Event (1st Monday of the month or biweekly, etc)

Event Start Time

02:30 PM

Arrival time for Setup

02:30 PM

# of Tables Needed:

Audio/Video Requested

Event End Time

02:30 PM

Clean up is complete

02:30 PM

# of Chair Needed

A/V Equipment Requested

Any further request notes:

Thanks for submitting! Our event coordinator will be in contact with you shortly!