Facility & Event Reservation Request Form

Please complete all appropriate sections of the form. Campus community request must include a department account number. Requests from off-campus organizations or individuals must include complete contact information. A certificate of insurance is required.

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

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: