Event Request Form

Date of Event: *

Name of Event: *

Group Sponsoring Event: *

Additional dates
(if applicable):

Event Start Time: *

:

Event End Time: *

:

Set-up Time (if needed):

:

Clean-up Time (if needed):

:

Number of People Attending: *

Contact Person: *

E-mail: *

Phone: *

Contact Person available during event: *

Phone during event: *

Room(s) Requested: *

GymSt. AndrewSt. AnselmEast OverflowConference RoomOther (list rooms below)

Other Rooms:

I would like to use this Room Set-up: *

Setup 1 (Presentation with tables and chairs)Setup 2 (Speaker with chairs only)Setup 3 (Large Banquet Gathering up to 240 ppl)Setup 4 (Small Banquet ie Funeral Lunch - up to 120 pp)Andrew/Anselm (8 round tables / 8 chairs per table)Andrew (4 round tables / 8 chairs per table)Andrew Meeting (4 rectangular tables)East Overflow (5 round tables)Conference RoomNone of these

Please enter a description of the room and setup:

Additional Items Requested: *

Paper plates, utensils, napkins, paper cups, plastic cupsRegular Coffee (includes cups, sugar, creamer, etc)Decaf Coffee (inludes cups, sugar, creamer, etc)Hot water (includes cups, sugar, tea bags)Ice water (includes cups)No additional items

Technical Equipment Requested: *

Video Cart (laptop, projector, DVD/VHS, speakers)Projection ScreenTV (includes DVD/VHS)PodiumNone Required

Additional Information:

Room Usage Rules

I have read and agree to follow St. Mary of the Hills room usage rules: *

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