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Koinonia Room Reservation Request
Group Without a Leader
Cell phone number
Campus mailbox number
Housing (Dorm & Room number)
List up to ten names and email addresses of people in your group. Groups must be all-male or all-female. Include yourself.
If you have less than ten people, would you like Koinonia to place additional people with you to form a larger group?
If yes, please list characteristics or preferences of people to be placed in your group.
Group type (check all that apply)
Special interest group/other
If you selected "special interest", please explain below.
Please list all preferences for a leader assigned to your group below. (Male groups will be given a male leader, female groups will be given a female leader).
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