Event request Form

First and Last Name

Email Address

Purpose of Event


Event Title

Start Time - End Time (for example 6pm-9pm)

What time do you want to start to set-up?

If this event will repeat, how often?

What is the cost to attend the event?

Is an RSVP required? By when and to whom?

Will childcare be provided?

If childcare will be provided, please obtain a Childcare Form/Policy sheet from Pastor Jolene. It needs to be turned in at least one week before the event. The Childcare Policy must be adhered to and all childcare workers must be approved by Pastor Jolene.

Event Location

If you selected Off Campus, where will the event be held?

Description of your event

Is there any special equipment or audio/visual technicians needed? Please be specific.

Promo Needs


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