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2. Your Name*
3. Your Email Address
4. Your Phone Number
8. Name of Facility*
10. Address of Facility*
12. Contact Person at Facility
13. Contact Person's Phone Number
14. Contact Person's Email Address
16. Does the facility have an open meeting room or fellowship hall?

    1. Yes
    2. No
    3. Unknown
18. Is there a minimum of 30 parking spaces available?

    1. Yes
    2. No
    3. Unknown
20. Is there adequate lighting in the parking area?

    1. Yes
    2. No
    3. Unknown
22. Does the room have ample power supply and multiple outlets?

    1. Yes
    2. No
    3. Unknown
24. Is the space shared with another group, organization, or business?

    1. Yes
    2. No
    3. Unknown
26. Is the building and room accessible to wheelchairs?

    1. Yes
    2. No
    3. Unknown
28. Is the location easily accessible to traffic?

    1. Yes
    2. No
    3. Unknown
30. Is the facility located in an area that is accessible to the general public (not in a gated community or restricted area)?

    1. Yes
    2. No
    3. Unknown
32. Please provide any additional information or comments about the facility.
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36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

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