Name of Contact Person/Responsible Party:
Phone Number where Contact Person can be reached: Alt phone #
Email Address of Contact Person:
Event/Meeting Information:
Description/Name of Event/Meeting:
Location Requested for the Event/Meeting:
Date Requested for the Event/Meeting: //
Time arriving for set up: AM PM
Event START Time: AM PM Event END Time: AM PM
Include announcement in: (check all that apply):
bulletin (deadline Tuesday) screen in Grace Hall (deadline Tuesday) Newsletter (deadline 20th of month)
Announcement text:
Will transportation be furnished (info. for bulletin purposes only-
if you require the use of the bus or van you must fill out a Vehicle Use Form): NO YES
Number of people you are expecting to attend:
Kitchen Supplies Needed (check all that apply): paper plates bowls dessert plates
plastic silverware 8 oz. Styrofoam cups 12 oz. Styrofoam cups napkins
other (list below)
Set up required by custodians (i.e. tables/chairs): Please note: the Custodians are only involved
in set-up and clean up on certain events. If the Custodians are not involved in set-up, it is the
responsibility of the person in charge of set-up to return furniture, fixtures, and/or equipment
to the original places; to follow the posted procedures in the kitchens (if the kitchen areas are
approved to be used); and to ensure that all doors are locked when the event is over).
Detailed Custodian instructions (list below):
Who will be locking and unlocking doors?
Audio/Visual Equipment or Supplies Requested:
(if you need a microphone, DVD player, or CD player note that here)
Office Assistance Requested: (such as programs, mailings, emails, etc.)
List any other information that you think might be helpful below: