Requested Room (Choose 1)*

Parish Center Hall (200)

Parish Center Kitchen

Parish Center Conference Room (60)

Parish Center Front Room (8)

Portables Youth Room (20)

Portables Music Room (20)

Church (600)

Requestor First Name*

Requestor Last Name*

Todays Date*

Requestor Email*

Requestor Phone Number*

Title of Event*

Number of Expected Participants (NOT ZERO)*

Date Room Needed*

Event Start Time XX:XX AM or PM*

Event End Time XX:XX AM or PM*

Event Setup Begin Time XX:XX AM or PM*

Event Cleanup End Time XX:XX AM or PM*

Is this a Recurring Request?*

Yes

No

Room Request

Please note the type of characters needed for each answer