Meeting Request Form

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The McConnell Foundation offers the use of its facilities on a complimentary basis to 501(c)(3) organizations, public schools, and government entities that agree with our Certification of Non-Discrimination. Groups are welcome to apply for space for special meetings, programs, and activities that fall outside the scope of their everyday business.

Please note: our space lends itself to scheduled meetings, trainings, or collaboratives that are relatively quiet in nature. We avoid scheduling groups that wish to do high-energy team building exercises, which don’t fit well with our own work environment.

Fields marked with an * are required

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Meeting Request Form

Organization Information

Organization *

Name *

Email *

Work Phone *

Type of Organization

Purpose of Meeting

Meeting Information

Please list 3 possible dates for your meeting.

Preferred Beginning Date 1 *

Preferred Beginning Date 2

Preferred Beginning Date 3

Number of Meeting Days

Number of Attendees *

Meeting Start Time

Meeting End Time

Meeting Arrival Time

Type of Meeting

Training
Board Retreat
Policy Making
Collaborative

Certification of Non‐Discrimination

I Agree to Certification of Non-Discrimination *

I certify that our organization does not discriminate (whether in its employment practices, provision of services, or otherwise) in regard to race, color, sex, sexual orientation, gender identity, marital status, pregnancy, political ideology, age, creed, religion, heritage, ancestry, national origin, veteran status, disability unrelated to job or course of study requirements, or any other characteristic protected by law. Organizations may target services to a specific population when the targeted group requires specialized programs to meet specific needs not shared by the general population. Additionally, an organization may provide targeted programs or services to redress current or past discrimination against a group. In the event you are unclear whether your organization complies with The McConnell Foundation’s Non‐Discrimination Policy, please provide detailed information in writing as to the nature of your organization’s practice, service or program in question to The McConnell Foundation so that a determination can be made by The McConnell Foundation, at its sole discretion. Please attach written explanation to this form, if needed. I also certify that I have full power and authority to execute this Certification on behalf of our organization.

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