Chelsea Recreation & Cultural Affairs

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

Oct 01, 2021
submission #9
Reservation Form

Contact Person

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

EVENT INFORMATION

Event/Activity Name ---
Leader's Name ---
Leader's Phone Number +16174665104
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 Room 302

Additional Questions

Will food be served? No

First Preference For Event Date

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

Second Choice - Single Date

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