Chelsea Recreation & Cultural Affairs

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

Jan 31, 2023
submission #68
Reservation Form

Contact Person

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

EVENT INFORMATION

Event/Activity Name ---
Brief Description of Event ---
School Building ---
Facility ---

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 2023-03-02
Total Time Needed (i.e. 2-6pm) ---
Set-up Time (i.e.2-3pm) ---
Event Time (i.e. 3-5:30pm) ---
Breakdown Time (i.e. 5:30-6pm) 7-730pm

Second Choice - Single Date

If your first choice date is not available, do you have a second choice? ---

Second Preference: One Date

Date ---
Total Time Needed (i.e. 2-6pm) ---
Set-up Time (i.e. 2-3pm) ---
Event Time (i.e. 3-5:30pm) ---
Breakdown Time (i.e. 5:30-6pm) ---
Space Needed ---
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.