Room Reservation Request

Submit this completed form to Circulation Services at the University Library (1st Floor) at least two weeks prior to the event. A confirmation email will be sent to the person making the request.

If all required fields (those marked with an asterisk (*)) are not completed, the form will not transmit.


*Contact Information Name
*Name of Group/Class
* Telephone	Include Area Code
*E-Mail
* Address
* City	* State * Zip

*Date of Event
*Time Requested
*Description of Event
*Room Requested	Room 181 Room 171 Room 123 (media not available)
Media Needed	Internet PowerPoint Microphone DVD/VHS
*Number Expected to Attend
*Open to the Public?	Yes No
*Will Admission Be Charged	Yes No
If yes, how much?	Students Others
*Do You Intend to Bring Refreshments?	Yes No Refreshments facilities in Room 181 only; no food or drinks in other rooms
If Yes, What?
Other

RESTRICTIONS

I understand that permission for use of these rooms is granted only for those specific activities listed on this request. I further understand that my organization and I will be responsible for all arrangements and for clean-up following the activity. A $25.00 fee may be assessed for clean-up, security or Non-USA requests. If needed each attendee will be responsible for obtaining a temporary campus parking permit from the University Police Department: 251-461-1481

* I agree to comply with these restrictions. Please read and check the box to agree with restrictions.