Activity Scheduling Form

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Please note: In order to complete your request, a minimum of one week notice will be needed.

Staff Contact Name *

First

Last

Staff Contact Phone Number *

Staff Contact Email *

Department *

Event Details

Name of Event *

Event Start (Date/Time) *

Date

Time

Event End (Date/Time) *

Date

Time

Total Time of Event (From Setup to Teardown)

Expected Attendance

Will You Need Check-In?

If yes, you must fill out an Planning Center Form in order to complete your request.

Will Childcare Be Needed?

If yes, please contact Jenn Clark to coordinate.

Food

Room Details

Room Location *

If Other, Explain...

Choose Room *

CCC Preschool Classroom *

Room Setup Needs

Number of Round Tables

Do You Need Skirts For Round Tables

Number of 8ft Rectangular Tables

Do You Need Skirts for 8ft Tables

Number of Chairs

Please Select Additional Needs Below

Podium
Dry Erase Board
Plastic Trash Cans/Bags
Stools
Easel/Tri-Pod

Number of Stools

Number of Easel/Tri-Pods

Audio/Visual

Does This Event Need to Be Recorded?

Number of Lapel Mics

Number of Handheld Mics

Number of Mic Stands

Numbers of Mic Stands w/ Boom

Please select any additional audio/video needs below:

Powerpoint Projector
CD Player
DVD Player
TV
Projection Screen
Zoom

Other

Any additional layout or setup maps can be emailed directly to John Swope.

Additional Requests & Information

Phone