Facilities Request Form

Your Name

Your Email

Group Name

Purpose

Expected Number of People

Date(s) Requested

Start Time

End Time

Room(s)/ Area(s) Requested

A/V or IT Requirements
Smart TVProjectorMicrophoneFull AV system in Worship CenterNone

Event Contact Person

Email

Cell Phone

I certify that I have read the summary of CPC Facilities and
Equipment Use Policies and that they will be followed.