Home of Cohen Hillel Academy

Please submit this form to reserve space for your event or meeting at Hillel Academy.

Contact Name:
Date of Request (mm/dd/yy):
Contact Email:
Contact Phone (000-000-0000):
Event Name/Description:
Event Date: (mm/dd/yy)
Event Time:
Room Requested
Services Requested
Kitchen Use	Yes No
If yes, please state day/date and time of kitchen use subject to approval	Day Date (mm/dd/yy) Time

For office use only:

Date Received:	Entered By:
Confirmed By:	Hillel Point of Contact:

Please note that your event is not secured until you have received a confirmation letter/email.

If you have any questions or need additional information, contact Ken Schulman at 781.639.2880.