Chelsea Recreation & Cultural Affairs

*CPS INTERNAL USE ONLY - Browne, Wright & Clark Schools Facility Request

Jan 20, 2023
submission #66
Reservation Form

Contact Person

Name/Last Name ---
Phone ---
Email Address ---
School Clark Avenue Middle School

EVENT INFORMATION

Event/Activity Name ---
Leader's Name ---
Brief Description of Event ---
School Building ---
Facility ---
If you selected classrooms, how many will be needed? ---
Total Estimated Number of Participants 20
Do you require special equipment or setup? ---
Please specify wifi and table set up outside of room for breakfast

Additional Questions

Will food be served? Yes

First Preference For Event Date

Is this event happening on one date or multiple dates? ---

First preference: Single Date - Time

Date 2023-02-11
Total Time Needed (i.e. 2-6pm) ---
Event Time (i.e. 3-5:30pm) ---

Second Choice - Single Date

If your first choice date is not available, do you have a second choice? ---
First Review by Recreation and Cultural Affairs

Decide which School should review this application:

Should Browne Principal review? No Browne Principal review necessary.
Should Wright Principal review? No, no Wright Principal review needed.
Should Clark Ave Principal review? Yes, Clark Ave Principal review needed.