Room Rental Request Form Room Rental Request Form – Providence Care Hospital You will be contacted with confirmation of the room booking, subject to availability. Applicant Information:Name:*Name of Organization:*Address:City:Phone Number:*Email Address:* Event Information:Name of Event:*Date of Event:* Date Format: MM slash DD slash YYYY Start Time:* : HH MM AM PM End Time:* : HH MM AM PM Type of Event/Description:*Number of Attendees:*Is your event exclusive to Providence Care attendees?*YESNODescribe who is invited to attend the event:*Registered Not-For-Profit Group:*YESNORegistration Number:Room: Founders’ Hall Classroom A Classroom B Combined Classroom A & B Classroom C Classroom D Admin A Meeting Room Computer Training Room Group Room (Large) Private Dining Room/Meeting Room Gymnasium Pool Vendor Display Area Additional Details:*Applicant’s Acknowledgement:* I certify that I have read the Providence Care Agreement and agree to abide by such terms.
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