Facility & Event Reservation Request Form

Contact/Applicant
*Name:
*Phone:
*E-mail:
Campus Organization Information
Group/Club/Dept:
Account no.:
Off-Campus Organization Information
Organization Name:
Address:
City:
State: Zip:
Certificate of insurance is required.
Event Information
*Event Title:
*Event Description:
*Date of Event:
*Do you want the event to be
on the master calendar?		 Yes No
*Setup Time: A.M. P.M.
*Time of Event: A.M. P.M.
*End Time: A.M. P.M.
*Tear Down/Cleanup Time: A.M. P.M.
Location Requested:
2nd Choice Location:
Planned Attendance:
*Target Audience: (check all that apply)
Students Faculty Staff
Public Private Event Child-appropriate
Parking or Safety Needs:
Will food be served? Yes No
Will alcohol be served? Yes No
You must contact the catering manager for menu options.
Would you like photography? Yes No
Would you like a news release? Yes No

Setup Information

Tables: 6-ft: Round:
Do you want the tables skirted? Yes No
Do you want the tables covered? Yes No
Catering tables will be included by the Catering Manager and do not need to be requested.
Chairs:
Podium:
Flip Chart(s):

Other setup needs:

Please specify desired room setup:
e.g., Theatre Style (chairs in rows, no tables), U-shape, Board Style (tables in block):

Audio-Visual Services Needed:

Microphone(s):
Data Projector (for computer):
Overhead Projector(s):
Slide Projector(s):
TV/VCR(s):
Screen(s):
Other AV needs:

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