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Facility Room Request Form
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Steps
1.
Applicant Information
(current)
This section is complete
This section is incomplete
2.
Room Request Details
This section is complete
This section is incomplete
Applicant Information
Organization / Business
Event Name (Type of Event)
Contact Person
Address
City
Province
Postal Code
Phone
Cell Phone
Email
Continue
Room Request Details
Option 1
Requested Date
Requested Date
Requested Time
Requested Time Start Time
—
Requested Time End Time
Facility
Room Selection
Option 2
Requested Date
Requested Date
Requested Time
Requested Time Start Time
—
Requested Time End Time
Facility
Room Selection
Number of Attendees
Is a kitchen required? (For warming purposes only)
Yes
No
Is setup required?
Yes
No
If "Yes", provide a floor plan:
Will you require tables?
Yes
No
If "Yes", how many tables will you need?
Will your event require chairs?
Yes
No
If "Yes", how many chairs will you need?
Will there be food?
Yes
No
Will there be alcohol served?
Yes
No
Will there be music?
Yes
No
Will there be dancing?
Yes
No
Special Instructions
By clicking on the submit button you are consenting to the voluntary collection, use and disclosure of your personal information in accordance with Section 26(d) of the Freedom of Information and Protection of Privacy Act. Personal information will only used for the purposes of the Facility Room Booking Process and will not be disclosed to any additional third parties unless directed by you. If you have any questions about the collection, use or disclosure of your personal information, please contact Claudette Haire, Business Services Manager at 3000 Guildford Way, Coquitlam BC V3B 7N2 or 604-927-3534.
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