Name *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Event

MM

DD

YYYY

Recurring Event?

Yes

No

Start Time (Including Setup)

Hour

Minute

Second

AM PM

End Time (Including Cleanup)

Hour

Minute

Second

AM PM

Do you plan to use one of our large halls? If so, please specify:

Blakeman Hall (capacity 300)

Wesley Chapel (capacity 300)

Wesley Lounge (capacity 100)

I do not plan to use a large hall

I need help deciding

Do you plan to use a multipurpose Room? If so, please specify:

LL102 (capacity 20)

203 (capacity 15)

204 (capacity 20)

211A (capacity 20)

211B (capacity 10)

211A&B (capacity 30)

Lobby/Front Entrance/Sidewalk

I do not plan to use a multipurpose room

I need help deciding

Do you need to use the kitchen?

Additional Fee will Apply

Yes

No

Will there be a fee to attend?

Yes

No

Is this event open to the public?

Yes

No

Do you need the piano?

Additional Fee may Apply

Yes

No

Do you need A/V equipment?

Additional Fee may Apply

Yes

No

Do you need Projector/TV equipment?

Additional Fee may Apply

Yes

No