Facilities and Communication Request Form

Facilities and Communication Request Form
BEFORE YOU SUBMIT YOUR REQUEST

• Please note the program or event reservation will first receive approval before it is confirmed.

• Please note your request must be submitted at least 4 weeks prior to the desired date if you wish the program or event to be publicized.
Contact Information for Program or Event Leader
Name *

First Name Last Name
Phone Number *

- Area Code Phone Number
Email *
example@example.com
Program/ Event Information
Name of Program/ Event *
Ministry that Program/ Event falls under *

Discipleship - Pastor Mark Crumpler/Admin. Assistant Nina Jaworski Mission and Outreach - Pastor Manuela Kauer/Admin. Assistant Yovita Wooden Women's Ministry - Pastor Manuela Kauer/Admin. Assistant Susan Smith Congregational Life and Care-Pastor Manuela Kauer/Admin. Assistant Yovita Wooden Trustees - Executive Director Jackie Etter/Admin. Assistant Kathie Welker New Member- Pastor Mark Crumpler/Admin. Assistant Yovita Wooden Session - Pastor Marnie Crumpler/Admin. Assistant Stacey Judge Nominating- Pastor Marnie Crumpler/Admin. Assistant Stacey Judge Other- Executive Director Jackie Etter/Admin. Assistant Kathie Welker Deacons-Pastor Mark Crumpler/Admin. Assistant Yovita Wooden Next Generation- Jodi Wycherley/ Admin. Assistant Nina Jaworski Next Generation- Denise Balik/ Admin. Assistant Nina Jaworski
Date of Program/ Event *

- Month - Day Year
Date
Start Time of Program/ Event *
End Time of Program/Event *
Set-up Time Needed *

None 1 hour 2 hours Other option
Breakdown Time Needed *

None 1 hour 2 hours Other option
Is this a recurring Program/ Event? If so, please list all dates (or date range) below.
Program/Event Detailed Description *
Please be specific (include why people should be interested and what they will get out of this program/ event).
Facility Needs
Desired Location of Program or Event *

Grace Church Locust Street Campus Other option
If the desired location is other than Locust Street Campus, please provide the address below.

Location Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Anticipated Number of Attendees *
Does your Program/ Event have facility needs (chairs/ set-up/ etc)? *

yes no
If you have facility needs (chairs/ set-up/ etc), please describe below.
Mobility Issues: The use of stairs may cause an issue for anticipated attendees. *

Yes No
Childcare
Will Childcare be Needed? *

Yes No
Registration
Is registration for attendance required? *

Yes No
Do you need online registration? *

Yes No
Registration Deadline

- Month - Day Year
Date
Communication Request
Will your Program/ Event require publication? *

Yes NO
Please note your request must be submitted at least 4 weeks prior to the date you wish the program or event to be publicized.
Graphic Design
Detailed Description of Publication Needs *
Please be specific (include why people should be interested and what they will get out of this program/ event).
Please describe what you wish the graphics to include.
Resources

Browse Files
Please attach any relevant images/files related to this program/event. Cancel of
Should be Empty:

Facilities and Communication Request Form

Contact Information for Program or Event Leader

Program/ Event Information

Graphic Design