Congregation Beth Israel Facilities Set Up Request Form

Event Name:
Event Date:

MonthDayYear
Expected Attendance:
Room(s) to be used:
Group/Organization Hosting Event:
Using Beth Israel as a drop off and pick up?:
Contact Person:

First NameLast Name
Contact Phone Number:

Area CodePhone Number
Contact Email:
Food and Beverage
Is this a catered event?

YesNo
Caterer Name:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Contact Name:

First NameLast Name
Contact Phone:

Area CodePhone Number
Contact Fax:
Facilitator must verify that caterer has
insurance per Beth Israel requirements.
Verified:

YesNo
Beverage Service:
Cups, stirrers, sugar, creamer, etc. will be provided with this service.
Check all that apply:

CoffeeDecaf CoffeeLemonadeWineIce WaterTea Hot WaterGrape Juice
Other Beverages
Further Instructions:
Paper and Plastic Products
Paper and plastic products will be used unless specific arrangements are made in advance.
Napkins:

DinnerHors d'oevres
Plates:

DinnerHors d'oevres
Cutlery:

ForksKnivesSpoons
Chaffing Dishes Requested:
Other Serving Utensils, Bowls, etc. (please list):
List any additional food or snacks being provided by organizer:
List any special food to be ordered separately by Facilities Coordinator:
Account Name to Charge:
Set Up
Please email any diagrams to help us with your set up needs to lsampson@cbisd.org
6' long tables:
8' long tables:
8' x 18" table (long, skinny):
60" round table (seats 8-10):
72" round tables (seats 10-12):
Trash Can Quantity:
Number of chairs needed:
Special table/chair requests (registration/shalom, etc.):
White Linen for banquet tables (120 x 54")
$5.00 fee per linen
White linen for round tables (85")
$5.00 fee per linen
Audio and Visual
List Quantity of Mics
Sanctuary allows for 3 wireless mics, Social Hall allows for 1 wireless mic, Chapel allows for 2 wireless mics
Audio and Visual

TV/DVDPodiumFlip ChartLCD ProjectorTVWhite Board w/ MarkersScreen
List outside vendors and their phone numbers for your event
Beth Israel Committee Meetings
For Beth Israel Committee Meetings, please indicate the following:

Breakfast MeetingLunch MeetingDinner MeetingMeeting, No Meal
Food will be ordered from:
Who is ordering food:

First NameLast Name
Munchies:

YesNo
Cookies:

YesNo
Soft Drinks:

YesNo
Chips:

YesNo
Account to Charge:
Shabbat Dinner
Shabbat Dinner Section

Shabbat Candles/Candle HoldersShabbat Blessing BookletManschevitzGrape JuiceMatchesShabbat 36" table (2 large Shabbat candles/holders, silver Kiddush cup, challah)Challah1oz Kiddush Cups
Number of Challah:
Number of 1oz Kiddush Cups:
Additional Notes:
Should be Empty: