2. 

4. Thank you for your interest in the Woodland Community & Senior Center. Please complete the below information and your request will be sent to the Community Services staff.  You will receive a communication soon about your request.

6. First Name*
7. Last Name*
9. Organization
11. Address
13. City
14. State
15. Zip Code
17. Phone Number*
18. Email Address*
22. Day(s) of Week
23. Event Date*
    Event Date
24. Room(s) Requested*

    Select all that apply

    1. Meeting Room
    2. Banquet Room
    3. Gymnasium
    4. Kitchen
    5. Other
25. Other room request
27. Event Start Time

    In the Facility

28. Event End Time

    In the Facility

30. Type of Event*

    Choose 1

    1. Assembly
    2. Concert
    3. Baby shower
    4. Birthday

    1. Carnival
    2. Company party
    3. Educational
    4. Family gathering

    1. Graduation ceremony
    2. Memorial
    3. Quincenañera
    4. Reunion

    1. Service group
    2. Wedding
    3. Wedding reception
    4. Other
32. Estimated Attendance*
33. Need use of *

    Check all that apply

    1. Microphone
    2. Screen
    3. Sound system
    4. None
    5. Other
34. Other needed items
36. Basic Room Set-up*

    1. Guests are not seated
    2. Guests seated at round tables
    3. Guests seated theater style with no tables
    4. Guests seated classroom style with rectangle tables facing front of room
    5. Other - please specify
37. Other room set up
39. Memorial Name
41. Other event
43. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
45. Electronic Signature
47. Banquet Room
    
48. Gymnasium
    
49. Meeting Room
    
50. Banquet Room
    
Leave This Blank:


52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

* indicates a required field