Media Request

Each ministry or department approved to use the facility is responsible for the set up and tear down of tables and chairs.  For more information, please refer to the Facility Usage Guidelines in the Facility Usage Policy.

Today's Date*

Class or Individual*


Date(s) of activity*

Day(s) of Activity (check all that apply)* (days of the week)

Building(s)/Rooms(s) Location*

Have you already requested the facility usage? If not, click here to request.*

Media Equipment Needed (we need seven days lead time)

Sound, LightingPPTPlay a DVD/VideoRecord on a church video cameraUse of a TV cart with BluRay/DVD playerOther not listedI do not have media needs

Comments (your assistance with setup is expected)

Contact Person

First Name*

Last Name*

Contact Phone*

Email Address*

Ok to text?*