Request Information

Bold Fields are Required

Contact Information
Name of Group (this must match the name that will be listed on your insurance):
Primary Contact Name:
E-mail Address:
Confirm E-mail Address:
Phone Number:
Fax Number:
Address:
Address line 2:
City:
State:   Zip:
Country:

Event Information
Briefly describe your event.
Approximately how many people will be attending?
Event Timing: First Choice
Start Date: / /
Start Time: a.m. p.m.
End Date: / /
End Time: a.m. p.m.
Event Timing: Second Choice
Start Date: / /
Start Time: a.m. p.m.
End Date: / /
End Time: a.m. p.m.
Facilities Desired: Classrooms
Meeting Rooms
Conference Rooms
Student Union Activity Center
Music Center
Auditorium
Gymnasium
Dining Hall/Cafeteria
Athletic Field
Apartments
Food Service Requirements: Cafeteria Catering None
Will you need housing? Yes No
If yes, for how many people? (required if yes to the above question)
Will you need any special setups? Yes No
If yes, briefly describe setup needed (required if yes to the above question):
Will you be able to provide your own liability insurance? Yes No Not Sure - Please Advise