CPC Room Reservation Request Form

Requestor/Contact Info

Contact Name:

E-mail:

Phone:

Status:
(CPC member, regular attendee, etc.)

Group Info

Group Name:

Type of Organization:
(non-profit, CPC ministry, private company, etc.)

Street:

City:

State:

Zip code:

Event Info

Event Name:

Purpose:

# of Participants:

Date(s):

Start Time:

End Time:

Setup Start Date & Time:

Cleanup End Date & Time:

Rooms(s) Requested:

Furniture:

Tables		How many?
Chairs		How many?
Podium
White Board

AV Equipment Needed:

Overhead Transparency Projector		Copy Equipment
Television		CD Player (Boom Box)
VCR		Conference Phone
DVD Player		Easel w/Pad and Markers
Audio Cassette Player/Recorder (must supply your own tape)

Any additional comments or requests?

Note: Submission of this request form does not guarantee a reservation. Request must be approved by CPC staff in accordance with CPC Mission Statement and Session guidelines.

(This page was last updated on March 3, 2007 )
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