AHS Room Rental Interest Form Name(Required) First Last Are you a Member of the Arc of Washington?(Required) Yes No, but please send me information to become a member Email(Required) Enter Email Confirm Email Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Please indicate the START time for your Event:(Required) Hours : Minutes AM PM AM/PM Please indicate the END time for your event:(Required) Hours : Minutes AM PM AM/PM Date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Please Indicate the Space & Services you are Interested in:(Required) Art Gallery/Studio Space (Capacity: 100 people standing/75 people with tables and chairs) Community Conference (Capacity: 15 people) Provide an A/V Set-up for your event Food/Drink Ordered through Chicco Baccello (on-site cafe) Food/Drink Provided through an Outside Vendor Comments(Required)Please share any additional comments about the event you are hosting that will help us ensure the best use of our space and services. Please Acknowledge:(Required) By submitting this form, you request a room reservation with the Arc of Washington located at 111 West Pike Street, Canonsburg, PA 15317. A two-week notice for room requests is preferred to guarantee your request can be fulfilled. You also understand that after completing this request form, a representative from the Arc of Washington will contact you to confirm the availability of the space. Once we have verified that your reservation can be processed, you understand that you will need to complete a Room Rental Agreement and submit payment for the room.CAPTCHA Δ