CSDHH Conference Room Request
Please fill out this form to request use of the CSDHH Conference room. Reservations are made on a first come, first serve basis.

*Please do not fill this form out if your request is with less than 24 hours notice. If you need to make a request with this short of notice, please contact us directly at info@csdhh.org, 336-275-8878 (voice), or 336-542-3981 (VP)*

What is your name? *
Your answer
What is your email address? *
Your answer
What is your phone number? *
Your answer
For the phone number listed above, is it a: *
Required
What is the type of meeting? *
Your answer
What is the primary language of the meeting? *
Is the meeting affiliated with any organization/company? *
Your answer
What is the date of your request? *
MM
/
DD
/
YYYY
What is the start time? *
Time
:
What is the end time? *
Time
:
Brief Description of Meeting: *
How many people, general content, etc.
Your answer
Submit
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