Room Request form

Date REQUIRED Please fill out this field. Please enter a date.

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Email REQUIRED Please fill out this field. Please enter an email address.

Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Phone Number Please enter a phone number.

Cell Phone Number Please enter a phone number.

Event Name Please enter valid data.

Single Occurence REQUIRED yes no Please fill out this field.

Multiple Occurrences yes no

Frequency of event Please enter valid data.

To Date: REQUIRED Please fill out this field. Please enter a date.

Desired Date(s) from: REQUIRED Please fill out this field. Please enter a date.

Day of the week Please enter valid data.

Setup Time: REQUIRED Please fill out this field. Please enter valid data.

Cleanup time: REQUIRED Please fill out this field. Please enter valid data.

Event Time: REQUIRED Please fill out this field. Please enter valid data.

Event end time REQUIRED Please fill out this field. Please enter valid data.

Number Expected REQUIRED Please fill out this field. Please enter valid data.

Room(s) requested

Room setup (St. Raymond Room Only)

Will you need Kitchen (Church Building only) yes No

Table Requested (St. Raymond Room and main building only)

# chairs needed Please enter valid data.

Equipment needed

Type of Access needed Key Code Have needed access

Publicity bulletin Calendar

Brief Description for bulletin

Saint Mark Catholic Church