Via Facility Use Request Form

Facility Use Request Form

Via is happy to be able to provide a place to host your event. Once we receive your submission we will review it. If we are able to host your event, we will contact you with additional details. Please provide the following information.
Organization Name*
Type N/A if no Organization
Contact Name*

First NameLast Name
Contact's E-mail*
Contact's Phone Number*

Area CodePhone Number
Organization's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Start Date/Time*

MonthDayYear
DateHourMinutesAM/PM Option
End Date/Time*

MonthDayYear
DateHourMinutesAM/PM Option
Event Details
Please provide a brief summary of the event
Is this a recurring event?*

YesNo
What are the expected dates of future events?
Estimate attendance
Room(s) Requested

Sanctuary & FoyerKitchenDownstairs classroom
Will you need sound equipment? (mics, projectors, etc)
Type the equipment you will need to use.
Will there be children attending? What are you needing for them?
Other comments we might need to know about your event.
Should be Empty: