NCC Room Request Form
Organization Name
*
Main Contact Person
*
First Name
Last Name
Contact Email
*
example@example.com
Date Requested
*
-
Month
-
Day
Year
Date
Second Date Requested if needed
-
Month
-
Day
Year
Date
Start Time of Event
*
Hour Minutes
AM
PM
AM/PM Option
End Time of Event
*
Hour Minutes
AM
PM
AM/PM Option
Approximate Number of People Expected
*
Please give details about the purpose and intent of this event.
*
Does this event serve refugees specifically?
*
Yes
Not specifically
I understand that this form is a request for space, not a reservation.
*
Please Select
Yes, I understand.
No, I need more help.
This acknowledgement acts as your signature.
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Submit
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