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Facility Use

Event and Information Form

Event date

Type of event

Name of event

Event starting time

Event ending time

Purpose of event

Names of speakers and entertainers

Name of organization hosting event

Address

Street 1

Street 2

City

State

Zip code

Type of organization


Please select one from above
If "Other" is selected, please describe.

Other:

Mission of organization

Name of authorized representative

Phone number


xxx-xxx-xxxx

Cell number


xxx-xxx-xxxx

Fax number


xxx-xxx-xxxx

Email address

Estimate maximum attendance

Description of expected attendees

Hours needed for set-up prior to starting time

Hours needed for load-out after event concludes

Space/site or sites requested

Board of Governor's Hall
Central Committee Room
Hall of Service
Red Cross Square's Memorial Garden
Other

Will alcohol be served?

Will media attend or cover the event?

Has the event ever been held before?

Date and location of previous event

Other organizations involved with this event and relationship

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