Thank you for considering the Alliance for your upcoming meeting or event.

First Name *

Last Name *

Please provide a phone number to reach you at. *

Please provide an email to reach you at. *

Please provide the name of your organization. *

Please provide the address of your organization. *

Is your organization a member of the Lynchburg Regional Business Alliance? *

Yes No I do not know

Do you need to rent a room for more than one consecutive day? *

Yes No

Please provide the DATE you wish to request to host your event at one of our three event spaces. *

Format: M/d/yyyy

If you need to rent a room for more than one consecutive day, please list the dates.

Please provide the START TIME you wish to request to host your event at one of our three event spaces. *

Format: hh:mm AM/PM

Do you need to rent more than one conference room? *

Yes No

Please provide the END TIME you wish to request to host your event at one of our three event spaces. *

Format: hh:mm AM/PM

Please Select Which Event Space You Would Like to Rent *

Centra Conference Center - Large Meeting Room That Can Hold up to 350 people Delta Star Executive Board Room - Mid-Size Meeting Room That Can Hold up to 15 - 35 people First National Bank Conference Room - Small Meeting Room That Can Hold up to 12 people

If you need more than one conference room, please select which additional event space you would like to rent.

Centra Conference Center - Large Meeting Room That Can Hold up to 350 people Delta Star Executive Board Room - Mid-Size Meeting Room That Can Hold up to 15 - 35 people First National Bank Conference Room - Small Meeting Room That Can Hold up to 12 people

Please Describe Your Event. (Purpose, Goal, Outcome, etc.) *

Please indicate what you will need for your event. (select all the apply) *

Tables Chairs Podium Audio/Visual

If tables & chairs are needed, please provide a number for each here.

By Checking this box, I understand that the Alliance does not set up tables and chairs. *

I agree

By Checking this box, I understand that I am responsible for resetting the room the way I found it, removing all trash, and removing all materials that I brought with me for this event. *

I agree

Do you need audio/visual equipment? If so, please describe. *

How many attendees do you expect to attend your event? *

Do you plan to have security? If so, please provide the company, contact name, and phone number. *

I ______ plan on using a caterer or providing a meal during my event. *

do do not

If so, please provide the contact information on your caterer or indicate that you are providing your own food.

Do you have any additional questions or comments?

Please select if you plan on serving alcohol at your event. *

There will not be alcohol at my event I plan on providing alcohol at my event

By Checking this box, I understand that this is an Event REQUEST Form and completing this form does not automatically guarantee my event at the Alliance Office. *

I agree

If you already have a description of your event, please upload it here.

Thank you for considering the Alliance for your upcoming meeting or event.

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