Chelsea Recreation & Cultural Affairs

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

Jan 27, 2023
submission #67
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 ---
Do you require special equipment or setup? ---
Please specify stage, mics, sound, chairs for audience, food set up in cafe

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 2023-05-25
Total Time Needed (i.e. 2-6pm) ---
Set-up Time (i.e.2-3pm) ---
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.