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:
Date of Event:
 
Setup Time:
Time of Event:
End Time:
Allow yourself time for setup and cleanup.
 
Location Requested:
2nd Choice Location:
 
Planned Attendance:
Will food be served?Yes  No
Will alcohol be served?Yes  No
You must contact the catering manager for menu options.

Setup Information

Tables:6-ft:Round:
 Skirted:Covered:
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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