Ron and Sheila Cuccaro Conference Room

Organization Name (required)

Address (required)

Are you a 501(c)(3)?
YesNo

Certificate of Liability Insurance (naming The Community Foundation of Herkimer & Oneida Counties):
---The Community Foundation already has this on fileI will submit this to estefanec@foundationhoc.org as soon as possibleI am submitting it with this request form
Upload Certificate of Liability Insurance

Primary Contact

Primary Contact Name (required)

Title

Phone Number (required)

Email Address (required)

Representative from Organization (Person who be overseeing meeting while at The Community Foundation)

Same as Primary Contact

Meeting Information

Meeting Name (as you want it to appear on signage):

Meeting Purpose:

Request Meeting Date (required):

Requested Setup Start Time:

Requested Meeting Start Time:

Request Meeting End Time:

Requested All Clear Time:

Requested Room:
Ron and Sheila Cuccaro Conference Room

Expected Number of Attendees:

Number of Tables Needed:

Number of Chairs Needed:

Do you need a projector?
YesNo

Do you have sound system needs (microphone, presentation with audio, etc.)?
YesNo

Please indicate if you would like beverages made available to your attendees.
Coffee/TeaWater

Additional Requests or Notes:

Check this box to confirm that you have read and understand the terms of The Community Foundation of Herkimer & Oneida Counties, Inc., Room Use Policies and Procedures and understand that violation of these policies may result in denial and/or cancellation of future use of The Community Foundation’s meeting rooms. Permission to use our conference rooms does not constitute sponsorship or endorsement from The Community Foundation for any organization, event or activity.