WRT Proposed Event/Program Planning Request Form

This form is designed to assist the Program Planning Group as we plan our exciting and stimulating calendar of programs. Please fill out this form for each suggested program. Thank you for your participation in this process.

Program Point Person *

Full Name

Contact Phone Number*

Area CodePhone Number

Number is...*

Contact E-mail*

Proposed Title of Event*

Brief Description of Event*

Name of WRT Professional [Clergy/Educator/Manager] liaison*

Type of Event*

Other type of Event

Proposed Date(s) of Event:*

Proposed Start Time of Event*

Proposed End Time of Event*

Is this Date / Time potentially flexible, in case there is a calendar conflict?*

YesNo

Projected Number of Adults*

Projected Attendees

Projected Number of Children

Projected Attendees

Proposed Event Location (check all that apply)*

*Other (rooms, atrium, outdoor spaces, etc.)

Will there be food served at/before/after the event? *

YesNo

If yes, what are you serving?

Who is providing food for this event?

Drop-offCaterer-servedOther