Floris Room Request

Name of Event:

Does this event meet only once?  Yes No

One Time Event
If yes, please answer the following:
          Date of Event:
          Start Time of Event: End Time of Event:
        Set-up Start Time: Clean-up End Time:

Multiple Meetings:
If No, please answer the following questions:
        How often do you meet?:
        What day of the week do you meet? (check all days that apply)
       Sunday     Monday     Tuesday     Wednesday     Thursday     
            Friday      Saturday     Monday-Friday     Sunday-Saturday

 
        Start Date:    End Date:
        Start Time of Event: End Time of Event:
        Set-up Start Time: Clean-up End Time:
        Do you plan on meeting on any of these Fairfax County School holidays? 
        If so, which dates? 

Fairfax County School Holidays (2008/2009 school year)
Oct. 13 Columbus Day holiday
Nov. 3-4 Student Holidays
Nov. 26 Students Released Two Hourse Early
Nov. 27-28 Thanksgiving Holiday
Dec. 24 - Jan. 2  Winter Vacation
Jan. 19 Martin Luther King Jr.'s Birthday Holiday
Jan. 20 Inaguration Day Holiday
Jan. 26-27 Student Holiday
Feb. 16 George Washington's Birthday - President's Day Holiday
April 3 Student Holiday
April 6-10  Spring Vacation
May 25  Memorial Day Holiday

Are there other dates you do don't plan to meet?
Estimated Number of People:

Equipment Needs: (Check all that apply)
TV/VCR/DVD     White Board     Lectern     Screen
Portable Sound System      Projector      Computer    
Overhead Projector         
             
Would you like this event on the Website Calendar? (Yes or No) 

If your group needs childcare, please click here for the guidelines.  You will be prompted to go the the childcare request form after you submit this request.

Additional Comments:

Contact Person:
Phone:
Email Address:

   (Please only click on Submit once)