Southeastern Live Well Center Room Reservation Interest Form

Southeastern Live Well Center Room Reservation Interest Form

Welcome to room reservations for the Southeastern Live Well Center!

If you are interested in reserving a room, please fill out the form below. Your reservation time must include set-up and clean-up time. The person requesting the room is the responsible party.

There are 3 rooms available to reserve with different capacities. Rooms may be combined to accommodate larger capacities (i.e., Room A & B can accommodate 110 people combined).

Room A – Capacity 71
Room B – Capacity 39
Room C – Capacity 71

There are 3 types of workspaces available in the Community Based Organization (CBO) Suite that are available to reserve:

Huddle Room: Small meeting room for up to 5 people
Workstation with a Computer
Workstation without a Computer

PLEASE NOTE: This form does not confirm your reservation. A team member will reach out to you about the status of your reservation in 3-5 business days via email.

For questions, please email SELWCReservations.HHSA@sdcounty.ca.gov.

**Disclaimer: Approved reservations are subject to modification/cancellation based on county emergencies and availability.**

Contact Information

Name of Requestor*

Please include your first & last name.

Organization Name*

Please write "N/A" if you are not part of an organization.

Organization Address*

Requestor's Email Address*

Requestor's Phone Number*

Phone

Who do you serve/who is your target population(s)?*

Please select all that apply.

Select

Please describe the other target population(s) your organization serves.*

Please add your organizations 501(c)(3)/license to ensure all necessary documentation is covered.*

Drag and drop files here or

Meeting/Training Information

Date Requested*

Meeting/Event Name*

Start Time*

Please include AM or PM.

End Time*

Please include AM or PM.

Is your meeting on a weekday, evening, weekend, or recurring?*

Select all that apply.

Select

Please select which areas you would like to reserve.*

Select all that apply.

Select

Room Requested*

Please select up to 3 conference rooms to reserve. Rooms may be combined to allow for larger capacity.

Select

Which type of workspace(s) in the Community Based Organization (CBO) Suite would you like to reserve?*

Select all that apply.

Select

Total Estimated Number of Attendees*

Number of County Staff Attendees*

Number of County Contractor Attendees*

Number of Public Attendees*

Anticipated Number of Parking Spaces Needed*

Additional Information

Will food and/or beverages be served?*

Select

What is the anticipated noise level?*

Will audio/visual equipment be needed?*

Select

Type of AV Equipment Needed*

Where did you hear about the CBO Suite?*

Please select all that apply.

Select

Please describe where you heard about the CBO Suite from.*

How will you utilize the space?*

Please select all that apply.

Select

Please describe how you utilize the space.*

Is there anything else we should know to help facilitate your booking?*

Send me a copy of my responses

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