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: Lisa Spidle. If special equipment is requested, please specify on the diagram where it should be placed. If you have questions regarding room layout, please call Lisa Spidle at (317) 591-5050 ext.101 or email lspidle@easternstarchurch.org.

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)