Facility Use Request Form


PLEASE NOTE: Conference rooms for meetings can be booked through a Department Secretary - This form is for EVENTS ONLY



BEFORE YOU BEGIN

 

Would you like to search for available locations for a specific date and time? If so Click Here.

 

APPLICANT INFO  MY PREVIOUS REQUESTS    REPORT A PROBLEM

 

Organization Name *

 

Organization Type *

 

Organization Contact *
First Name Last Name

 

Phone *
- -
(###) ### ####

 

Email *

 

Organization Address *
Street Address 1
 
Street Address 2
 
City State Zip Code

EVENT DETAILS

 

Activity Title *

 

Activity Description *

 

Website Link (Optional)

 

# Of People Expected To Attend Event *

 

This Event Is Intended For *




 

Location *
   Help - Location Details

 

Location Template Setup
   Help

 

To Enter More Locations Click Here

 

Date *
Month Day Year
    Help
 

Activity Begins *
:
Hour Min AM/PM
    

 

Activity Ends *
:
Hour Min AM/PM
    

  To Enter More Dates And Times Click Here


SETUP REQUESTED

 

Amount of Lecturns/Podiums

 

Microphones

 

Common Media Usage Requests






   

 

Special Requests

 

Signature *
By typing your name, you certify that you are an authorized representative of the organization listed in this form.

PROOF OF INSURANCE LIABILITY COVERAGE FOR ACTIVITY AND PAYMENT IN FULL REQUIRED NOT LATER THAN TWO WEEKS BEFORE EVENT TO CONFIRM EVENT. MY PREVIOUS REQUESTS    REPORT A PROBLEM
 
 
 
 
Click the button above to open the confirmation page. Users must confirm their entries on the confirmation page to submit their request to our office

PLEASE NOTE: Completion of this form does not reserve the space requested. Please await confirmation by an event coordinator prior to announcing events.