Parish / School Name:

City:

Contact Name:

Phone:

Email:

Please indicate the name and phone number of someone we can contact after hours in the event of a session needing to be cancelled (due to weather, funeral, etc.)

Date of Session:

Time of Session:

Anticipated Number of Participants:

Do you need a facilitator assigned for this session? 
  YES        NO

If "NO", who will be facilitating this session for you?

Will this be a Closed Session?     YES       NO

 (A "Closed Session" is for only those YOU invite, i.e., a special inservice for teachers or volunteers.)

We have video equipment that can accommodate:  
   VHS    DVD     Both

Is the space where the session will be held handicap accessible?
  Yes     No

Comments:  (Include special instructions:  "Session will be held in the Lower Level of the Parish Center", etc.)

A confirmation will be sent to you and the facilitator when this has been scheduled on-line with VIRTUS.

If you have any questions regarding this form, please contact Rita Beatty at 651-251-7742 or email cfm@archspm.org.  Thank you.