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Mt. Washington Conference Center
6225 Meeting Request Form
6225 Meeting Request Form
Department:
(Required)
Date:
(Required)
MM slash DD slash YYYY
Planner for Meeting:
(Required)
Office Phone:
(Required)
Email:
(Required)
On-site Contact Name:
(Required)
On-site Contact Cell Phone:
(Required)
Job Title
(Required)
Date(s) Meeting Space Needed:
(Required)
Expected Total # of Attendees:
(Required)
Name of Meeting:
(Required)
Room Set-up
Susquehanna Room Set-up (please choose one):
Theater (Max Capacity 170)
Rounds ( Max Capacity 120)
Reception (Max Capacity 200)
Patio: Existing Set, 10 Picnic Tables with 4 Chairs Each
Dining Room: Existing Set, Seating up to 110
Atrium: Reception Style Available
**Some rooms might require rentals of tables, chairs, and A/V equipment
A/V Needs
A/V Needs (please check all that apply):
LCD & Screen
Microphone
Please List the Quantities Needed for Each Item Selected Above:
(Required)
Meeting Timeline: Please Give a Rough Timeline of Events:
Client Arrival Time:
(Required)
Event Start Time:
(Required)
AM Break Start
(Required)
Lunch
(Required)
PM Break
(Required)
End of Event
(Required)
Catering Needs (Please select all that apply)
Breakfast Options (please check all that apply)
Continental
Hot Buffet
Lunch Options (please check all that apply)
Boxed
Cold Buffet
Hot Buffet
Reception
Yes
No
Additional Requests
Would You Like Any Additional Beverages Sold A La Carte? The Following Services Are Available:
Coffee/tea by the gallon (list quantity below)
Additional soda/water (list quantity below)
Quantities for Additional Beverages:
Would You Like This To Be a Zero-Waste Event? (compostable disposables)
(Required)
Yes
No
Please Select From One of Our Catering Options:
Rouge Catering
Classic Catering
Do You Require Any Additional Items for Your Meeting?
CAPTCHA
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