Member Request Forms

Member Request Forms

Your Member Number (required)

Your Name (required)

Your Email (required)

Your Telephone (required)

Candidates Name (required)

Candidates Date of Birth (required)

Candidates Gender (required)
MaleFemale

Address (required)

City (required)

State and Zip (required)

Mother's Name(required)

Father's Name(required)

Select Preferred Month(required)
FebruaryAprilJuneAugustOctoberDecember

Your Member Number (required)

Your Name (required)

Your Email (required)

Your Telephone (required)

Candidates Name (required)

Candidates Date of Birth (required)

Candidates Gender (required)
MaleFemale

Address (required)

City (required)

State and Zip (required)

Mother's Name(required)

Father's Name(required)

Select Preferred Month(required)
JanuaryMarchMayJulySeptemberNovember

Your Name (required)

Auxiliary/Organization (required)

Contact Person (required)

Contact Telephone (required)

Date(s) to be included in Bulletin (required)

Kingdom News Announcement (required)

Any Graphics?
YesNo

If so, we will contact you with specifications,

PLEASE CHECK ABOVE FOR ERRORS, THANK YOU

Date Submitted (required)

Date Required (required)

Your Name (required)

Auxiliary/Organization (required)

Contact Person (required)

Contact Telephone (required)

Number of Pages Submitted (required)

Number ofCopies Requested (required)

Special Requests: Please label each sheet with special instructions and/or provide detailed instructions below.

Uploads (.doc, .jpg or .pdf only)

"Please Allow 24 Hours for your request to be fulfilled. For larger orders, please allow 48 hours. You may pick up your copy order from the front office."

Auxiliary/Organization (required)

Todays Date (MM/DD/YY)

Contact Person (required)

Telephone (required)

Cell Phone

Email (required)

Type of Event (required)

Frequency of Event (required)

Start of Event: Date (required) (MM/DD/YY)

Start of Event:Time (required)

End of Event: Date (required) (MM/DD/YY)

End of Event:Time (required)

More Dates/Times? Please list additional information:

Number of Guests (seating will be based on this number) (required)

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Area(s) Requested

Multipurpose RoomNew Multipurpose RoomSanctuaryDomeJohn Huff Hall

Meeting Room AMeeting Room BMeeting Room CMeeting Room DMeeting Room EConference Room A

KitchenetteWest Lobby (outside Dome)East Lobby (Main entrance)Parking Lot EastParking Lot WestOther

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Room Arrangements / Other Requests

Room Set-Up

Auditorium StyleConference StyleHead TableRound TablesBanquet Tables-6ftBanquet Tables-8ft

Equipment Needed
MicrophonePodiumProjectorTVScreenChalk BoardCD PlayerDVD PlayerVHS PlayerLaptopPhone TapVideo Recording

Other
Security NeededGreeters NeededUshers NeededCollection/Offering

Additional Items (costs apply)
Catered FoodLinenNapkins
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Any additional questions or concerns?

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