BEWC Meetings and Events Request Form

Meetings and Events Request Form
Contact Information
Name:

First NameLast Name
Email Address:
example@example.com
Phone Number:
Format: (000) 000-0000.
Organization Name:
Billing Information
Billing Entity:
Event Details
Description of Event:
Date of Event:

MonthDayYear
Date
Start Time:

Hour Minutes

AM/PM Option
End Time:

Hour Minutes

AM/PM Option
Target Number of Attendees:
Event Set Up Time:

Hour Minutes

AM/PM Option
Event Break Down Time:

Hour Minutes

AM/PM Option
Event Type:
Chosen Event Area:
Event Logistics
Is your event's organization a Non-Profit or Government Agency?
Will there be food catered?
Event Equipment
Audio/Visual Equipment Needed?
If so, please specify (check all that apply)
Microphone Needed? (Maximum 4)
If so, which type? (check all that apply)
Table and Chairs Needed?
How many Chairs (maximum 100):
How many Tables (maximum 12):
Event Personnel
Do you need Event Setup and Breakdown Services? (Minium 4 Hrs.)
Do you need Event Cleaning Services? (Min. 4 Hrs.)
To confirm your booking, please sign and date below
Signature
Date

MonthDayYear
Date
Bethel Empowerment and Wellness Center
1429 McCulloch Street | Baltimore, MD 21217
Should be Empty:

Meetings and Events Request Form