GCC Intake Form

Please help us serve you by completing the required information.

No Outside Food

* = Required

Customer Name:*
Phone (Primary):*
Phone (Secondary):
Email Address:*
Alternate Point of Contact (Alt. POC):*
Alt. POC Phone (Primary):*
Alt. POC Phone (Secondary):
Type of Function (ie. Military function, birthday party):*
Requested Date:*
Alternate Date:
Requested Start Time:*
Requested End Time:*
Number of Guests:*
Requested Room/Venue:*
Would you like a sign placed on the door during the function? YesNo
If "Yes", what should the sign say?
Additional Requirements:

For security, please type the code that appears in this image below:*