Group Name________________________________________________________________________________
Purpose of Meeting/Activity_____________________________________________________________________
Requested Room(Rooms)_______________________________________________________________________
Date of Event___________________ Time _________________________ Duration_______________________
Expected Attendance_____________________
Contact Person Information:
Name________________________________
Home phone__________________________
Work phone__________________________
Cell phone____________________________
Email________________________________
Support Services Requested (please provide drawings for specific room setups 7 days prior to event)
Tables______ Chairs________ Sound Equipment ___________
Coffee/tea setup?______________________________________
Other_______________________________________________
____________________________________________________
____________________________________________________
Note: Submission of this form does not guarantee the requested event will be scheduled. Worship services, funerals, and weddings have priority over all other events at PHUMC. PHUMC reserves the right to relocate or postpone any scheduled event when necessary. Once approved, assigned space is limited to the space specified on this form. Use of additional space requires additional authorization. Please make requests for support items and setups 7days prior to event. Please return rooms to original configuration. Do not move conference tables in rooms 207 and 209
PHUMC Office Use: _____Event approved as requested, _____ Approved with Modifications, _____ Declined Setup submitted ___Yes ___No