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Activity Request Form


Activity Request Form
Make reservations at least five working days in advance.  Please check availability of the facility by calling 479-524-5176, before filling out this form. Harvard Avenue Baptist Church reserves the right to deny any request for facility usage.
Date of Activity:   (mm/dd/yy)
Date Request Submitted:   (mm/dd/yy)
Name of Activity: 
Activity Coordinator: 
Phone Number: 
E-mail Address: 
The Time Facility Needs to be Set Up: 
Facility or Room(s) Needed: 
Actual Start/Stop Times for the Event: 
Anticipated Attendance: 
Check All Equipment Needed:
 PA System  TV/VCR Cart         LCD Projector
 Screen                    Overhead              

Other (Please Describe)
Number of Tables & Type:
Number of Chairs: 
Please describe the desired room set-up below:



Bible Study 
Worship | 10:30am

Student Ministry | 5:30pm
Children's AWANA | 6:00pm
Prayer Gathering | 6:00pm