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2. 
4. Name*
5. Email*
7. Address*
8. City*
9. State*
11. Primary Phone*
12. Secondary Phone
14. Date of Birth
15. Emergency Contact Name & Phone
17. Type of Event
18. Will there be alcohol?

    1. Yes
    2. No
19. Will you need hotel room(s)?

    1. Yes
    2. No
21. 3 Event Date Options
    Please provide 3 date options.
23. 1st Option*
    1st Option
24. 2nd Option
    2nd Option
25. 3rd Option
    3rd Option
27. Time of Event
    Time of Event
28. Hours of Event
29. Attendance
31. Room Request
33. Room Requests & Booking Information
    Monday-Thursday Rentals:
    All reservation requests must be received at least two weeks prior to event.
    
    Friday-Sunday Rentals:
    Full ballroom space may be reserved up to one year prior to event.
    Half ballroom space may be reserved up to six months prior to event.
    Two-third and one-third ballroom spaces, and other small rooms, may be reserved up to one month prior to event.
    
    All deposits are due at the time of the scheduled rental meeting.
    Any remaining balance will be set up on autopay with an electronic check or credit card. Any insufficient funds may void your contract. A credit card will be kept on file for any additional damages/costs that may occur. You will be notified before your card is charged.
    
    Reservations made three months or less from event date require payment of full balance at the scheduled rental meeting.
37. Event Enhancements (please select all that apply)

    Prices are noted by all amenities.

    1. Stage: 20 feet by 20 feet for $300
    2. Stage: 20 feet by 40 feet for $400
    3. Dance Floor: 20 feet by 20 feet for $125
    4. Dance Floor: 40 feet by 40 feet for $250
    5. Ceiling Projector/Screen for $100

    1. Portable Projector/Screen for $50
    2. Table Linens: $5 Each
    3. Chair Covers: $3 Each
    4. Uplighting: $75
39. Note

    Please keep a copy of this form for your records. This request does not confirm your reservation for any date at the Portland Community Center. THIS IS A REQUEST FOR A RESERVATION.

    
    

    We will review your request and contact you within 7 business days.

    
    

    For questions or to schedule a facility tour, call 361.777.4684; 361.777.4685 or email laura.jasso@portlandtx.gov 

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41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit

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