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Goodwin House Facility Usage Request
This form must be received at least two weeks prior to requested event date.
Organization
Your answer
Contact Person
Your answer
Phone
Your answer
Email
Your answer
Requested Event Date
MM
/
DD
/
YYYY
Requested Event Start Time
Time
:
Requested Event End Time
Time
:
Is this a Recurring Event
Rooms Requested
Number of Individuals Attending
Your answer
Will you be serving food/drinks at this event
Event Description
Example: meeting, fundraiser, phone bank, work session
Your answer
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