Room Request Form

* required

* First Name: * Last Name:

* Email: * Phone:

* Requested Date:

* Number of People:

* Start Time:

* End Time:

Preferred Room(s):
 Board Room #208  Fellowship Hall #100  Kindergarten Room #109

 Kitchen #115  Memorial Room #217  Parlour #209

 Primary Room #214  Sanctuary #201  Youth Room #117

Equipment Requested:

Message:

* 3 x 3 =