This form is to be submitted by CHURCH GROUPS only. For all other building usage, please contact our office administrator at [email protected] or by phone at (815) 744-9020.

Name *

First

Last

Church Group/Committee *

Email *

Phone Number *

Date and Time of Event *

Expected Number of Guests *

Purpose/Description of Event

of Announcements use)

Space(s) Needed *

• Dickens Room
• Kitchen
• Sanctuary
• Murray Room
• Covenant Woods
• Bathrooms (if using outside areas)
• RE/Nursery Room
• Other Outdoor Area

If kitchen is needed, do you have a licensed food handler or professional catererKitchen not neededKitchen needed, we have a licensed food handlerKitchen needed, we do NOT have a licensed food handler

Technology Needed (Please indicate all you may use)

• Not Sure, please contact me
• Hybrid Meeting/Online Presentation (scheduled via Teams)
• Microphones/sound system
• Smart TV (laptop can be connected with HDMI Cord or it can be casted to)

Supplies Needed (indicate number for tables/chairs)

• Piano
• Garbage Cans/Recycling Bins
• Chairs
• Tables

Special Instructions or notes to the office

Indicate number of chairs/tables or other supplies needed. If you’re meeting off hours, indicate who will be unlocking / locking the building.

Please mark all communications you would like for your event:

• Newspaper
• Website
• Email Blast
• Printed and Online ScUUp
• Facebook
• X (Twitter)
• Sunday Announcements
• Printed Flyers

Write Blurb for ScUUp and Announcements

Submit