First Presbyterian Church Event and Facility Use Request Form
Facility Use Request Form (Website Version)
Please fill out this form completelyand return to the church administrative office.
If Publications are requested, please also complete and turn in the Ministry Publications Form.
Note: Requests for FOOD SERVICEmustbe received at least one week in advance.
*All requests are contingent upon approval of FPC Program Staff (Phone 757-625-1697 Fax757-625-1288)
EVENT INFORMATION
Event Description:
Event Date (s): From: To:
Event Purpose/Target Group:
Event SetupStart/End Time:am/pm to am/pm
Event Start/End Time: am/pm toam/pm
Event Coordinator Name (s):
Event Coordinator #1 Contact Info: Home Phone:Cell Phone:
Email Address:
Event Coordinator #2 Contact Info: Home Phone:Cell Phone:
Email Address:
Event Frequency: One time only Weekly Bi-Monthly Monthly times per Month
Other (Please Explain):
Event Room Requested: First Hall Fellowship Hall Commons Breezeway Rabbi Room
Rooms 201 202 203 204 205 206 Armstrong Chapel
Conference Room Northminster House The Center Sanctuary
Door Warden Needed?: Yes No
FOOD SERVICE
Beverage Service Only: Coffee Tea Lemonade Water w/ice Ice Only
Meal Service:
FPC to cater? Yes No If no, please explain
Meal Desired:Breakfast Lunch Dinner Meal Type: Light FareBuffetSit Down
Head Count:EstimatedFinal # of Adults # of Children If estimate, final #’s to be determined by: (Date)
CHILD CARE NEEDS
Child care needed? Yes No Not yet defined;To be determined by (Date)
How many children do you expect?
# Preschool children (4 Children to 1Adult ratio; 2 adult min.)
# Elementary children (6 Children to 1 Adult ratio; 2 adult min.)
Childcare start time? am/pm Childcare end time? am/pm
MiscellaneousChild Care Notes:
ROOM SETUP
Setup Needed? Yes No Not yet defined;To be determined by (Date)
Type of Set Up: # Round Tables # Chairs # Rectangular Tables Skirted? Yes No
Describe Room Setup (Please submit diagram of room setup no later than 5 business days prior to event):
Special Needs Setup (Please Explain):
AUDIO VISUAL
Locaion of Event: ______
Sound Equipment needed? Yes No Not yet defined;To be determined by (Date)
# Microphones: #Wireless Handheld (4 available) #Wireless headset (1 available)
# Microphone Stands # Music Stands (use as podium)
CD Player TV VCR DVD Whiteboard Laptop & Smartboard (room 205/206 only)
Large Screen(s) for PPT presentations or DVD(First Hall or Great Hall only) Easel
Video Equipment needed? Yes No Not yet defined;To be determined by (Date)
2 Cameras for Projection on screen (4 available) DVD recording (2 cameras)
Additional Personnel/Services needed? Yes No Not yet defined; To be determined by (Date)
Stage Cleared Audio Engineer Technical Director Lighting Designer DVD Duplication
HD Recording Live Streaming (includes HD recording)
Other Equipment needed? Yes No Not yet defined;To be determined by (Date)
Miscellaneous AV Equipment notes:
VEHICLE REQUEST (All drivers and requests for church vehicles must be approved in advance by church administratoranddrivers must be on the church insurance policy.)
Bus needed? Yes No Not yet defined; To be determined by (Date)
Van needed? (For hauling use only – no passengers) Yes No Not yet defined;To be determined by (Date)
OFFICE USE ONLY
Request Received on ___/___/______
______Approved ______Not Approved
Updated Church Calendar _____/_____/______Initials _____
Notified Promotion Team _____/_____/______Initials_____
Notified Child Care Coordinator _____/_____/______Initials _____
Notified Food Service _____/_____/______Initials _____
Notified AV Team _____/_____/______Initials _____
Notified MST Team _____/_____/______Initials _____
Notified Security Team _____/_____/______Initials _____
NOTES:
Please save this file to your computer and email to:
* attach additional information if necessary Revised 11/10/11