Name First Last Organization Phone NumberBest Time to Reach : Hours Minutes AM PM AM/PM Please note that this person should be the main contact for this event. This person will be in charge of keys, set-up and clean-up. This person is to see that, when the event is over, the rooms used are in good condition, appliances are turned off, the lights are shut off and the room is locked up.Event Start Date MM slash DD slash YYYY End Date (if different) MM slash DD slash YYYY Start Time : Hours Minutes AM PM AM/PM End Time : Hours Minutes AM PM AM/PM What room(s) do you need? Church Gym Kitchen Auditorium Art Room Music Room Classrooms Other If you intend to use the kitchen please check specific needs in kitchen Ovens Stove Dishwasher Refrigerator Freezer Aprons Coffee Urns/Pots Dishes/Silverware Salt/Pepper Holders Sugar/Creamers Please ExplainDo you need set up time Yes No Date MM slash DD slash YYYY Time : Hours Minutes AM PM AM/PM Do you need keys to the building? Yes No Do you need maintenance help for set up? Yes No If yes, what do you need? Please describe: (ie; tables arranged, tables washed, floors swept, number of chairs, etc.)Please attach a drawing of how you’d like the room set up.Max. file size: 64 MB.Do you need any special equipment? Microphone/PA LCD Projector Projection Screen Piano Podium Easel Board/Paper Blackboard Lighting Board/Stage Lights Other Please ListDo you need special supplies? Yes No If no, you must supply your own.If yes, please explain: (ie; markers, table clothes, paper plates, etc.)Clean-up Date MM slash DD slash YYYY Clean-up Time : Hours Minutes AM PM AM/PM SOMEONE MUST BE RESPONSIBLE FOR DISPOSING OF LEFT OVER FOOD. DO NOT LEAVE IT IN THE REFRIGERATOR. SOMEONE MUST BE RESPONSIBLE FOR GETTING TRASH BAGS TIED AND PLACED IN THE DUMPSTER. YOUR GROUP IS ALSO RESPONSIBLE FOR ANY DAMAGES DONE TO EQUIPMENT OR PROPERTY.NameThis field is for validation purposes and should be left unchanged.
