Facilities  Request Form

Before filling Out this Form, Please refer to:

Facility Policy

Technical Resources Available

Facility Photos/Amenities/Maps

Name (full name or organization)
Facility Request for which campus?
Today's Date:
Name of Facility you are requesting
Contact Information:

Individual's Name:

Phone:

Address: 

E-mail:
Date(s)  Facility Needed
Give Starting and Ending Time of Day when you  Will Need Factility (not optional)
Please give the following information:  
Purpose of Request (What activities will be held in the facility?)
Number of People Attending (estimate)
Support Personnel Needed? 

Examples: Custodian, Technical Support (PA System, Lights, Sound, Projection System), Security Personnel

 

 YES    NO
If you answered YES to the previous question, please list all types of support you will need.
Who is responsible for cleaning and securing the facility?
Any other information you would like to give?
Any questions you would like to ask?
What is the best way to reach you and when?
When you are satisfied with your input, please press submit.