Name of group*

Event description*

Contact name*

Contact phone number*

Contact email

Date and time requested

First choice (use format YYYY-MM-DD):

Time:

Second choice (use format YYYY-MM-DD):

Time:

This will be a recurring event

How many do you anticipate attending?*

What type of space or specific room(s) are you requesting?*

Require use of the kitchen

Do you need any special equipment? Audo/visual?

Questions or comments

Note: For events outside of office hours, it is normally necessary to hire our custodian to handle building security, room setup, property logistics.