Activity Request Form

Your name *

Email address *

Primary Campus *

Phone Number

Ministry *

Calendar Clearance

Name of Activity *

Purpose of Activity *

Date of Activity *

Start/End Time *

Set-up Time *

Charge (if any) *

Are Permission Slips Required? *

Need to Promote Event?

Leave unchecked if promotion not necessary.

Rooms requested *

Equipment requested *

Need Childcare?

Leave unchecked if childcare not necessary.

If the activity is to be held away from our facilities, list the location with the address and phone # below:

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