Chelsea Recreation & Cultural Affairs

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

Nov 15, 2023
submission #119
Reservation Form

Contact Person

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

EVENT INFORMATION

Event/Activity Name ---
Leader's Name ---
Leader's Phone Number +16174665100
Brief Description of Event (please be as thorough as possible) ---
Total Estimated Number of Participants 100
School Clark Avenue Middle School
Space Needed ---
Do you require equipment or setup? ---
Please specify what equipment you need/set-up projector & tables
Will food be served? Yes

Additional Questions - Food

Please explain what kind of food, how it will be stored, etc.. Yes, hot food & cold drinks.

First Preference For Event Date

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

First preference: Single Date

Date 2023-12-20
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) 7-7:30pm

Second Preference?

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.