Erlanger:

Date Needed:

Beginning Time:

End Time:
(Please include clean-up time in your request)

Purpose of Meeting:

All meetings shall be open to the public.

Estimated Attendance:

Equipment Needed:

Room Setup:

Will refreshments be served?  Yes No

Organization

Organization Name:

Organization Phone:

Organization Address:

Organization City:

Organization State:

Organization Zip Code:

Purpose/Type:
(i.e. educational, recreational, etc.)

Non-profit organization?  yes no
Non-political organization?  yes no

Organization's Authorized Representative

Your Name (required)

Title:

Representative Address:

Representative City:

State:

Zip Code:

Representative Phone: (required)

Representative Work Phone:

Your Email (required)

Additional Information:

Print Friendly