Highland Church Ministry Room Request
Please fill out the following information to request a meeting room at Highland Church. If you have any questions regarding special accommodations or would like more information about specific rooms, contact Lavonne Wright, Ministry Liason at reception@highandny.org.
Date of Request
-
Month
-
Day
Year
Date
MINISTRY INFORMATION
Name of Ministry
*
Recurring Meeting Frequency
*
Please Select
Weekly
Monthly
Bi-Monthly
Date of Meeting
*
-
Month
-
Day
Year
Date
Start Time (HH:MM)
*
Hour Minutes
AM
PM
AM/PM Option
End Time (HH:MM)
*
Hour Minutes
AM
PM
AM/PM Option
Name of Contact
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
E-mail
*
example@example.com
Expected Number of Attendees
*
Description of Meeting
*
ROOMS
Room(s) Being Requested
*
#1 (3rd FL) Capacity: 20
#12 (2nd FL) Capacity: 12
#13 (2nd FL) Capacity: 12
Other
Number of Chairs Needed
*
Number of Tables Needed
*
0
1
2
3
4
54"x108" Rectangular
24"x36"Rectangular
Will food be served at this meeting?
*
Yes
No
Electronic Signature
*
Submit
Form Reviewed by Staff Member
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Should be Empty: