Community Resource Center Space Request Form
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The Community Resource Center is not accepting requests at this time. We apologize for the inconvenience.
Please fill out this form to request space at the Bon Secours Community Resource Center.
Have you or do you currently partner with BSCW?
Brief Description of organization (if applicable):
Name of Organization / Individual:
Organization
Individual
Contact Person:
First Name
Last Name
Email
Mobile Number
Address
Address Line 2
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Postal / Zip Code
Reservation Details:
Setup Time Required
Cleanup Time Required
Space Requested: Bon Secours Community Resource Center (check all that apply)
Multipurpose Room
Media Room
Meeting Room
Art Room
Gymnasium
Rooftop Garden
Purpose of reservation and description of event
Event Name (if applicable)
Expected Number of Attendees
Date(s) Requested
Start Time
End Time
Special Requests
Additional Information:
E-Signature
Date
Acknowledgment:
Terms and Conditions
I acknowledge that submission of this form is only a request for space at the CRC and that a representative will contact me at my provided contact info to discuss the details of this request and provide any supplementary information.
Will there be a fee for attendees of this event?
Yes (please specify)
No
If yes, please specify
Is your event private or open to the public?
Private
Open to the public
Will food be served at your event
?
Yes (please specify)
No
If yes, please specify
Will alcohol be served at your event
?
Yes (please specify)
No
If yes, please specify
Will amplified music be played at your event?
Yes (please specify)
No
If yes, please specify
Will you be selling goods or services?
Yes (please specify)
No
If yes, please specify