Request Cooper House Use

Nonprofit Organization*
Person Requesting*
Phone*
Email*
Please tell us the purpose of your use of the Cooper House? (e.g., board meeting, staff meeting, board retreat, etc.)*
Date Requested
In the times listed below, please include the times before and after the meeting you will need to set up and clean up.
Date Start*
MM slash DD slash YYYY
Time Start*

: Hours

Minutes

AM/PM
Date End*
MM slash DD slash YYYY
Time End*

: Hours

Minutes

AM/PM
If you plan to leave for lunch, what time do you expect to be gone? (This information will help our staff to coordinate lunch breaks. You may provide this at a later time if you do not know yet.)
Approximate Number of Attendees
Approximate Number of Cars
Day of Event Contact Name
Day of Event Contact Cell Phone
Day of Event Contact Email

Date Requested