Event Request

Event Request Form

Please complete this form in its entirety at least 30 DAYS prior to your event.
Planner's Information
Your Name *

First Name Last Name
Submitted on behalf of

First Name Last Name
Email *
Secondary Email
example@example.com
Phone Number

Area Code Phone Number
Supporting Home Church Staff Member

First Name Last Name
Supporting Staff Member (Please contact prior to using their name) *
Event Information
Event Title *
Date of Event/Start Time *

Month Day Year Hour Minutes AM/PM Option
Day of the Week
Event End Time *

: Hour Minutes AM/PM Option
Setup Time *

: Hour Minutes AM/PM Option
Departure Time (est. end time for clean-up) *

: Hour Minutes AM/PM Option
Event Type *

One-time event Ongoing event Short-term ongoing event
How Often Does It Occur?

Weekly Monthly
Event End Date (For ongoing events, a new request should be submitted yearly)

Month Day Year
Date
Requested Room *
Number of Anticipated Guests *
Brief Description of Event *
Is this event related to the Mission of Home Church? (Helping Families Flourish, Transforming Lives through Christ)

Yes No
Describe how it relates to the mission:
Set Up Information

Some rooms have a standard setup
Seating Style *

Standard Setup Classroom Style Theater Style
If other, please describe:
# of Chairs
# of Tables
Special Instructions
Media/Technical Needs
Choose All That Apply *
Audio *

CD Player iPod Connection Podium (w/Mic) Handheld Mic Live Music None
Visual *

Laptop Projector & Screen DVD/VCR TV Extension Cords None
Recording Needs
Please note that if you would like the meeting recorded, each attendee will need to sign a video release waiver.
Additional Comments
Additional Facilities Needs
Equipment
Kitchen Access Requested?

Yes No
Briefly describe your Kitchen Needs:
Kitchen Overseer
Persons Responsible for Clean Up
Staff Person for Lock Up
Monday-Thursday nights the premises must be vacated by 9:30 pm
If Childcare is requested, please fill out this Childcare Request Form in addition to checking the box below.
Childcare Requested?

Yes No
Communication

Please Note: Approval of communication requests will give you space on our website, e-newsletter and Facebook. Announcements are chosen at the discretion of the Staff.
Communication Requested

Yes
Sunday Sign Up Counter

Yes
Preferred Starting Date:

Month Day Year
Ending on

Month Day Year
Email or Link for Electronic RSVPs
Registration Includes Payment

Yes
Please upload any promotional files you already have

Browse Files

Cancel of
Printing Requests (flyers, posters, etc.). 2 weeks advance notice required.
Should be Empty:

Event Request Form

Planner's Information

Event Information

Set Up Information

Media/Technical Needs

Additional Facilities Needs

Communication