Rental Exchange Program - Request Form
Please check our availability calendar on-line: http://www.counterpulse.org/availability-calendar/

Pricing: https://bit.ly/2EQmBKP
For event rentals, pricing will vary and will be worked out with staff.

Full Legal Name *
Your answer
Company or Organization
Your answer
Type of Rental *
Location *
Required
Day / Date / Time(s) of event - http://www.counterpulse.org/availability-calendar/ *
Your answer
Estimated Attendance *
Your answer
Description for Workshop/Class or Event/Performance (indicate n/a if for Rehearsal) *
Your answer
What kind of technical, set-up, and front of house support is needed for your event? --- A/V Equipment Requests (e.g. Microphones, Projectors, Playback Audio)
Your answer
Front Of House/Set-Up Requests (e.g. Tables and Chairs)
Your answer
Email *
Your answer
Billing Address *
Your answer
Phone Number *
Your answer
Are you a CounterPulse member? (Members receive a discount: http://counterpulse.org/join-2/)
Are you able to protect the space and keep our prices low for artists / low-income community by contributing an additional 20% for this booking? (Pricing: https://bit.ly/2EQmBKP, for events, detailed pricing to be worked out with staff)
We’d love to hear from you! How did you hear about CounterPulse? Why would you like to work with CounterPulse?
Your answer
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