Room/Space Request Form

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Today's Date *

Submit request 2 weeks in advance of date needed.

Contact Person *

First

Last

Email *

Ministry or Department *

Phone *

Event/Class Meeting Name *

Date(s) Needed *

Start/End Time Needed *

Location Requested *

Space Requested *

How many attendees or participants do you anticipate being present in the space. *

How many tables and was size table do you need? *

Space Setup (Room/Fellowship Hall) *

Other Setup Info *

Resources Needed for Meeting Space *

A/V Equipment Needs *

Other Equipment/Resource Needs (please describe) *

1760 Phillips Road
Lithonia, GA 30058
Phone: (770) 484-9300

14147 Highway 278
Covington, GA 30014
Phone: (770) 787-6226