RENTAL REQUEST FORM

TDC RENTAL REQUEST FORM
The information you provide in this application will be used to determine if space is available for rent. Requests should be made no later than 14 days in advance of rental date. Please allow 3-5 business days for a response to your request. Please fill out form completely. Your response will come electronically from the following email: info@dreamcenterharlem.org. Please make a note of it for your inbox. Please Note: This is a form in 2 Parts: The Form and The Facilities. It takes approximately 5 minutes to complete.
PART I: THE FORM
1. RENTER; INDIVIDUAL, ORGANIZATION, OR COMPANY
Name *
Event Title *
Type of Event *

Meeting Rehearsal Special Event Workshop Forum/Discussion Panel Fair/Information Driven Event Program/Class/Community Session(s)
Please provide a brief synopsis of the event. *

0/25
Attach a proposal (optional)
Contact Name *

First Name Last Name
CONTACT NUMBER *

Area Code Phone Number
Fax Number
Contact E-mail *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Are you a 501(c)3? *

YES NO
If yes, please provide your Tax ID Number:
2. NEEDS OF REQUEST
REQUESTED DATE *

Month Day Year Hour Minutes AM/PM Option
2nd CHOICE *

Month Day Year Hour Minutes AM/PM Option
3rd CHOICE *

Month Day Year Hour Minutes AM/PM Option
Please indicate the total number of expected participants. *
LOAD IN TIME

: Hour Minutes AM/PM Option
EVENT START TIME

: Hour Minutes AM/PM Option
EVENT END TIME

: Hour Minutes AM/PM Option
LOAD OUT TIME

: Hour Minutes AM/PM Option
We are requesting this to be a reoccurring rental.

Yes No N/A
Do you plan to charge for this event? *

Yes No
PART II: THE FACILITIES
This questionnaire helps us better assess your needs so that we can send you an accurate quote. Please answer as completely as possible.
Do you have liability insurance for this event? *

Yes No N/A
Please provide a brief description of your room set up *

0/25
Requested Room(s) *

Creative Arts Room Leadership Development Room Economic Empowerment Room The Lobby We'd like to rent the entire space
Will you need any of the following for your event? (Check all that apply)

Laptop(s) Table(s) Chair(s) TV Speakers Podium Mac Adapter VGA Adapter
How did you hear about The Dream Center? *

Search Engine TDC Website Referred by a Friend/Business Social Media Emails/Newletters Neighbor of The Dream Center
Should be Empty:

TDC RENTAL REQUEST FORM

PART I: THE FORM

PART II: THE FACILITIES