LCC Facility Request Form
Name of Group or Event *
Your answer
Event Description *
Your answer
Estimated Attendance *
Your answer
Date *
MM
/
DD
/
YYYY
Beginning Time (including setup) *
Time
:
Ending Time (including cleanup) *
Time
:
Requested Areas (check all that apply) *
Required
Technical / Equipment Needs
Additional Needs
Your answer
Primary Contact Name *
Your answer
Primary Contact Phone *
Your answer
Primary Contact Email *
Your answer
I have read the facility use policy and I agree to the stated terms and conditions. I understand that a $50 deposit may be requested and due within 3 days of making a reservation. Any additional fees are due one week prior to the event. *
Required
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