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: 

 

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: