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Facilities Request Form
Fill out the form below with your information.
Questions? Call the office at (541) 899-1287
Download the PDF Instead
Contact Info
Contact Name
Contact Email Address
Contact Phone
Alternate Phone
Event Info
Event Name
Purpose of Event
Anticipated Attendance
Event Start Date
Event Start Time
Time Required for Preparation
Event End Date
Event End Time
Time Required for Teardown
Event Day(s)
Monday
Tuesday
Wednesday
Thursday
Friday
Satuday
Sunday
Event Repeats?
One-Time
Weekly
Monthly
Yearly
Other
Usage & Rooms
You may indicate the room(s) that you prefer, however, you will be assigned rooms based on your event size, the requirements for concurrent events, or the need to setup for future events.
Rooms Requested
Multi-purpose (400)
Classrom (201-40)
Classrom (202-20)
Classrom (101-20)
Classrom (102-40)
Classrom (103-30)
Classrom (104-30)
Classrom (105-30)
Fellowship Hall (Historic Church)
Nursery
Kitchen
Sanctuary (Historic Church)
Other
Coffee / Beverages Requested?
Yes
No
Beverage Details
Use of Kitchen Requested?
Yes
No
Food Provided By
Beverages and/or food are allowed in some rooms. The person responsible for providing food for your event must obtain authorization to use the kitchen prior to the date of your event
Tables & Chairs
Desired Room Configuration
A
B
C
D
E
F
G
H
I
# of Tables
Registration Tables
Coffee / Drink Tables
Food Tables
Other Tables
# of Chairs Needed
Audio / Visual Equipment Quantities
Microphone
Music Stands
Overhead Projector
Television / DVD
Other A/V Items
Gatekeeper
A/V Tech Requested
Projectors Requested
Other A/V Needs?
Most audio visual equipment will require operation by a qualified technician. This may require special setup and an additional use fee.
Thank you! Your form has been received!
Call the office if you haven't heard back from us in a few days.
(541) 899-1287
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