Use this form to reserve rooms or church facilities for meetings, rehearsals, and events.

Space Request

MEETING & REHEARSAL SPACE REQUEST & SET-UP

IMPORTANT:  Submit to Administration Office during Annual Planning period; New request must be submitted 15 days in advance

Ministry Name*

Ministry Lead Name*  

Email

Phone for Event Lead/Coordinator( )   -

Alternate Contact Number( )   -

Fax ( )   -

Date Requested* 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 2025 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901

NOTE: You will receive an email confirmation of APPROVED dates/times

2nd or Alternate Date Request 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 2025 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901

If the event if multiple days, please indicate more in the text area below

Additional Dates Requested

Please indicate additional dates related to the above referenced event

Expected Number of Attendees*

Start Time of Event*

Please include the set up time prior to start of event

End / Break Down Time*

Location(s) of Event*

Sanctuary

Room 203

Fellowship Hall

Lower Nursery

Other (please specify)

Please indicate the areas or rooms which this event will be held (please ensure you receive email confirmation of space or room availability)

Set up Requirements*

TV/VCR

Laptop Computer

Overhead Projector/Screen

Podium

Microphone (contact Media Ministry)

SmartBoard

Easel

Other (please specify)

Set-up Requirements/Equipment Request: Please select the desired equipment and the location for your set-up. NOTE: Set-up & equipment should be coordinated with the Operations Department except where noted.

Number of Long Tables*

If none enter "0"

Number of Round Tables*

If none enter "0"

Number of Chairs*

DESCIBE LAYOUT DESIRED*

Please detail where you would like the tables and chairs to be placed; to include registration tables (if neededs)

Support Set Up: *

Operations Set-Up: Complete information on reverse; Submit & Coordinate with Operations Office (Operations@NewSamaritan.org)

Media Support: Contact Sister Eather Chapmon Waldron (eacwaldron@verizon.net)

Please check all that apply. NOTE: It is the ministry leader’s responsibility to coordinate requested service.

Operation Hours

NOTE: The Church and buildings close at 8:30 p.m. Monday – Thursday; Use on Friday requires prior approval; Saturday & Sunday at 4:30 p.m.
unless prior approval is given.

FOR INTERNAL USE ONLY:

NOTE:  THE DETAILS OF THIS EVENT HAVE BEEN SUBMITTED TO THE FOLLOWING SUPPORTING MINISTRIES. 

IMPORTANT:  Event Leads are to coordinate and communicate with the checked Supporting Ministries prior to event.    

FOR INTERNAL USE ONLY: Support Ministries

Culinary

Escort

Hospitality: Sister LaVern Johnson

Marketing / CDT Graphics Designer

Media: Sister Eather Waldron

Music & Arts: Sister Cathy Randall

Operations: Brother Robert Young

Security: Deacon Edywn Corless

Transporation: Deacon Robert Wood

Usher Ministry: Sister Charlene Batts

Each event Lead should coordinate and communicate with the following support ministries PRIOR to the event

FOR INTERNAL USE ONLY: CDT Liaison Support Team Member

The person listed below will be your CDT Liaison Support. This person will work with to ensure the proper coordination of your event.

Please leave this field blank.

• Submit your request for reimbursement of approved church-related expenses.

We are the New Samaritan Baptist Church (NSBC) On-Call Volunteers—a dedicated team of individuals serving to support and strengthen NSBC outreach efforts.

We support NSBC outreach activities/events by providing the additional team members with the skills, knowledge, and expertise needed to bring the event to a successful conclusion. Our participation is in a supportive role only.

Request for volunteer assistance will be submitted to VCM by NSBC Ministries outlining their need.  You will be contacted to gage your availability to serve depending on the amount time, skills, or expertise required for the event. 

When called upon, you will be asked to serve a minimum of 2 hours at the assigned event, but you may serve more if you are willing and able.

VCM currently meets via zoom quarterly and in person 2 times a year. 

Ministry Lead:                    
Arlene Wimbley-Jordan                                                       

Ministry Co-Lead               
Kisha Gordon                         

Ministry Sub-Lead            
Brigitte Porter                         

VCM Email:                  

  
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