Your name   

Your phone number   

Your email address   

Your group's name   

Number of people attending   

Starting date        Ending date   

Starting time        Ending time

Day of the week    Sun.    Mon.    Tues.    Wed.    Thurs.    Fri.    Sat.

How often will your group need the room(s)?    Just this once    Weekly    Twice a month    Monthly    Other, please describe   

Would you like to request a specific room(s)?   

Would you like the room(s) set up?    Yes    No

Please note the items you need:

Flip Chart    Podium    White Board    TV    VCR    Overhead Projector    Boom Box    Other, please describe

Number of chairs you need set up   

Number of tables you need set up   

Choose your table style (if need be, describe below)    Round    Rectangular

If need be, describe the event's set-up

Are you serving a meal?        Yes    No

Are you serving snack/coffee        Yes    No

Is this event catered?        Yes    No    If yes, by whom?