Name of Organization:*
Contact Person:*
Your Title: (For all conference correspondence)*
Mailing Address:*
Phone:*
-
E-mail:*
Person Responsible for financial obligation:*
Event Title & description of activity:
Expected number of attendees:*
Is your group a non-profit 501(c)(3) organization?*
Start Date:*
End Date:*
Start Time:*
 : 
End Time:*
 : 
Preferred rooms (if any):
Request for alcohol present during event?*
Any anticipated ticket/retail/vendor sales?*
Campus Housing or Accommodations needed?*
Catering needed? *
Dining Services Café meal tickets needed?
Do you forsee any audio-visual requirements?*
"Other" requirements:
Do you forsee any musical equipment? ($125.00 Tuning Fee for Piano):
"Other" musical equipment:
Set-up Requests:
Podium Quantity:
Head Table Quantity:
Beverage Food Table Quantitiy:
"Other" set-up requirements:
Arrangement* (Some rooms have standard set-ups):*
"Other" special arrangements:
Word Verification: