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

Contact Person

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

EVENT INFORMATION

Event/Activity Name	---
Brief Description of Event	---
Facility	---
Do you require special equipment or setup?	---

Additional Questions

Will food be served?

Yes

First Preference For Event Date

Is this event happening on one date or multiple dates?

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First preference: Single Date - Time

Date	2023-03-14
Total Time Needed (i.e. 2-6pm)	---
Set-up Time (i.e.2-3pm)	---

Second Choice - Single Date

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

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Attachments

Please upload any attachments (proposed site plan)

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