Ministry’s Name*

Presider’s Name*

Name of Event

Date of Event*

If Possible, Would You Like the Event to be in the Bulletin?
YesNo

I’d Like To Request the Following Room

Event Contact Person’s Name*

Event Contact Person’s Phone*

Event Contact Person’s Email*

Meeting Start Time
—123456789101112—00153045—AMPM

Meeting End Time
—123456789101112—00153045—AMPM

Set Up Time

Cleanup Time

Is This A One Time Event?
YesNo

Day of the Week for Recurring Event

Date Range for Recurring Event
–

Frequency of Recurring Event

Number of Guests Expected

Meeting Equipment Requirements (Check all that apply)
Rectangular Table (30" x 96") (Max: 55)Rectangular Table (30" x 72") (Max: 4)PodiumTV/DVDPlastic Chairs (Max: 300)Microphone

Additional Information