Venue Request Form - 5200 Midlothian Turnpike, RVA

Phone number

Name of Organization and Type of Event (Please state if Non-Profit Community Organization.) *

Expected Attendance (Please include staff and volunteers) *

Date(s) of Event (Please provide preferred and alternate dates) *

Start Time *

End Time *

Reservation Space Request *

(Please check all that apply)

Entire Facility includes Administration Offices

Lobby

Welcome Room

Sanctuary

Meeting Room - Yellow Room

Meeting Room - Blue Room

Meeting Room - Red Room

What is your Venue Rental budget? *

Resources needed for a successful event. (Number of Tables, Chairs, Audio/Visual, Production) *

Additional Comments