Room Request Form - Eastern Star Church

Room Request Form
(for ESC ministries and JCA only)

Please fill out this form to request a room for a meeting or other event.

Ministry:
Contact Name(s):
Phone:
Your Email:

Event Name:
Event Start [Day,Date, Time(am/pm)]:
Event End [Day,Date, Time(am/pm)]:

Room Access Time
Entry (for Preparation/Set-up):
Departure (After clean-up):

Event Open To:

Church

School

Public


Number of People Expected to Attend:

Equipment:		Special Services:
6' Tables	#:	JEWEL Audio Technician
8' Tables	#:	Bulletin Announcement
Cafeteria Tables	#:	Public Relations (TV, Radio, Print Media)
Chairs	#:	Print Materials
Overhead Projector	#:	Other
Projector Screen	#:	Refreshments (Room Preference/Needs):
TV/VCR	#:	Main Kitchen
Podium	#:	Family Life Center
Microphone	#:	Banquet Room
Other		Other

Room Layout
Please Note: If set-up is needed for multiple rooms, please fax room layout/drawings and a print out of this completed online form to (317)591-5060, ATTN: Venessa Abram. If special equipment is requested, please specify on the diagram where it should be placed. If you have questions regarding room layout, please call Venessa Abram at (317)591-5050 ext.101.

Number of Conference Rooms Needed:
Number of People per Room:
Additional Detail:

Chairs:	Circle
	Semi-Circle
	Lecture
	Theatre
	Other
Direction Facing:	North South East West
Additional Detail:

Tables:	T-shaped
	Horseshoe
	Banquet
	Lecture
	Other
Direction Facing:	North South East West
Additional Detail:

(PLEASE PRINT A COPY OF THIS FORM FOR YOUR RECORDS)