Rental Request Form

[contactform email=”facilities@flcva.org” subject=”FLC Facility Request” success=”Thank you for your facility request! We will review your request and get back to you soon to discuss fees, availability and space requirements.” captcha=”true”]
[name label=”Name of User/Organization” required=”true”]
[textfield label=”Phone Number” required=”true”]
[email label=”Email Address” required=”true”]
[textarea label=”Address of Organization” required=”true”]
[textarea label=”Contact Person (if different from user)”]
[textfield label=”Contact Person’s Phone & Email”]
[select label=”One-Time or Recurring Use?” value=”Single Use, Recurring Use” required=”true”]
[radio label=”If recurring use, please select the day(s) of the week you would like.” value=”M, T, W, Th, F, Sa, Su”]
[textfield label=”Date(s) Requested” required=”true”]
[textfield label=”Time(s) Requested” required=”true”]
[textarea label=”Describe your event” required=”true”]
[textarea label=”Room(s) requested, if known”]
[textfield label=”Anticipated Attendance” required=”true”]
[textarea label=”Describe Set-Up Requested (tables, chairs, A/V needs)” required=”true”]
[select label=”Type of User” value=”Individual FLC Member, Individual Non-FLC Member, FLC-Affiliated Organization (An organization comprised primarily of FLC Members), FLC-Sponsored Organization (An organization not comprised primarily of FLC Members but sponsored by at least one FLC Member), Non-FLC Sponsored Organization (Not for Profit), Non-FLC Sponsored Organization (For Profit)” required=”true”]
[textfield label=”If sponsored, please identify the FLC Member who is sponsoring this group (name and phone number)”]
[/contactform]