Rental Application - Long Island Community Hospital Amphitheater

Facility Rental Application

FACILITY RENTAL APPLICATION

PLEASE REMIT TO LIEVENTSAMP@GMAIL.COM

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Event Name:

Day/Date Requested:

Secondary Date:

Hours of Event:

Your Name:

Organization:

Address:

Telephone:

E-Mail Address:

Projected Attendance:

Ticket Price:

Artists (If Applicable):

Sponsors (If Applicable):

Additional Information:

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