Facilities Request Form

Facilities Request Form
Use this form to request a room for an event or program.

+ Events cannot be schedule more than 6 months in advance. All events are subject to change due to church facilities needs.

+ Events cannot be scheduled on a Friday or Saturday without a conversation with the Director of Operations, Roland Huysman.

+ Event is not scheduled until approval email is received from Kim Ripley.

Deadline to complete this form is 3 weeks before event.

Need this event advertised? Make sure you fill out our Communication Request Form 3 weeks before your event.
Your Information
Full Name *

First Name Last Name
Phone Number *

Area Code Phone Number
Email *
Are you the Contact for the event? *

Yes No
Please enter the name and email of the main contact below.
Full Name of Contact *

First Name Last Name
Email of Contact *
Program/Event Information
Name of Program/Event *
Ministry Area *

Worship Music Children's Ministry (18 mo-5th grade) Student Ministry (6th-12th grade) Adult Ministry (includes Men's, Women's, LIFE, etc) Serve Prayer and Care
Name of Ministry Director

First Name Last Name
Date of the Event *

Month Day Year
Time Event Starts *

: Hour Minutes AM/PM Option
Time Event Ends *

: Hour Minutes AM/PM Option
Recurrence of Event *
Enter specific dates (MM/DD/YYYY) *
Enter notes about your event's dates. (Ex. Last day of event cycle is 02/12/2016 or the event won't happen in May and June, but will continue in July.)
Number of Participants (Room have min. number of participants to be better stewards for turning on A/C or heating) *

Less than 10 people 10-20 people 21-50 people 51-100 people More than 100 people
Room Request (1st Choice) *
Room Request (2nd Choice) *
Nursery Needed? *

Yes No
FLC Commercial Kitchen Needed? *

Yes No
Certified Food Handler Needed? *

Yes No
Amount of Money to be collected at the event *

Money will not be collected Less than $500 More than $500
Notes/Additional Instructions
Set Up
Please tell us as many details as possible. Set up should be finalized with Ray Singleton, Head Custodian.
Is Set Up Required? *

Yes No
How Early is Set Up Needed? *

30 Minutes Before 1 Hour Before 2 Hours Before 3 Hours Before
How many chairs are needed?
How many round tables are needed?
How many rectangular tables are needed?
Set-up wanted
Attach a drawing of set-up needed *
Audio/Visual Needs (Must be discussed with A/V Specialist, BJ Figat, to be finalized)
Type of Request (Select all that apply)

Audio (Microphone, Music) Video or Slideshow (Projector, DVD Player)
Resources (Ex. slideshow or music)
Resources (Ex. slideshow or music)
Setup Details - please be as specific as possible
Hospitality Needs (Must be discussed with our Director of Involvement, Kim Ripley, to be finalized)
Would you like greeters at the door for your event?

Yes No
Share this Request with anyone?
Send email to:
Send email to:
Should be Empty:

Facilities Request Form

Your Information

Program/Event Information

Set Up

Share this Request with anyone?