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
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*Date of Event
*Time Requested
*Description of Event
*Room Requested

(media not available)

Media Needed
*Number Expected to Attend
*Open to the Public?



*Will Admission Be Charged



If yes, how much?
Students     Others
*Do You Intend to Bring Refreshments?


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.

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