Frederick Church of the Brethren : Contact: Room Reservation & Audio/Video Reservation & Setup Request Form

*** ALL FORMS SUBMITTED 1 WEEK IN ADVANCE ***

Requester:

Contact Phone:

Or e-mail:

Date(s):

to:

Start Time(specify am/pm):

End Time(specify am/pm):

Subject/Title of Meeting:

FCOB Member:

Please check this box for the Standard Setup: i.e. 1 Large Rectangular Table with 10 Adult Chairs.


Custom Setup: Please check the box(es) below as applicable:
	Tables (Qty): Rectangle: Large: Child's: Round:
	Chairs (Qty): Adult: Child:
	TV
	DVD/VCR (please specify)
	Satellite Connection (CCN)
	Computer Projector
	Microphone (Qty):
	A/V: I will need an Audio/Video Technician to help run the above equipment
	Projection Screen
	Other/Misc. Notes:
* All Detailed needs for A/V equipment must be directed to Josh Grossnickle at Josh.Grossnickle@fcob.net and jgrossni@umd.edu*
* All Kitchen User Requests go through Linda Shultz (lshultz23@hotmail.com or 301-662-5617)*
IF the A/V Box is not checked, an A/V Tech will NOT be available

Configuration of room:

If Other (please describe here):

Identify First (1) & Second (2) choice
if you have a Specific Room request
Room # (seating capacity)

First:

Second:

If Other (please describe here):

NOTE: All Saturday & Sunday facility reservations require a key to be acquired from church office on Friday prior to 5:00 pm.

Bernie Gower - FCOB Director of Facilities (301) 662 - 1819 Ext.25 email: bernie.gower@fcob.net

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