Noroton Presbyterian Church Event Request Form

Requestor Signature:

Date:

Information Below Must Be Filled Out By Requestor

Contact Group and Person:

Address:

Phone:

Number Expected:

Will Event Need (yes or no)

Kitchen Access (NPC Members Only):

Nursery School:

Sound Technician:

Chairs:

Tables:

Equipment:

Type of Equipment:

Event Type: (Meeting, Seminar, etc.)

Date Submitted:

Requested By:

Desired Date(s)

From:

To:

Alternate Dates

From:

To:

Start Time:

End Time:

Room(s) Requested:

Outside Location:

FOR OFFICE USE ONLY

Setup Time:

From:

To:

Fee:

$

Date Approved:

Approved by: