FH Reservation Request Form

First Name *

Last Name *

Email Address *

Phone Number *

Beginning Date *

Ending Date (if multiple days)

Do you Attend the Roanoke AC Church? *

Yes

Which church are you affiliated with? *

Purpose *

Which room is needed? *

Suggestion Donation: $75

Suggestion Donation: $150

Suggestion Donation: $250

Suggestion Donation: $175

Suggestion Donation: $250

Suggestion Donation: $50 / day

Suggestion Donation: $25

Suggestion Donation: $0

Suggestion Donation: $100

Suggestion Donation: $200

Suggestion Donation: $300

Suggestion Donation: $225

Suggestion Donation: $300

Suggestion Donation: $50 / day

Suggestion Donation: $50

Please type any notes here: