Utility / Facility Request Utility / Facility Request Form Name Untitled Member Non-Member Contact phone:HomeCellDay/Work (Provide the best phone number to call and the time to call) Email Address Secondary contact Name Phone # Type of Event:Date of Event: Estimated Number of Attendees: (This will determine your space)Time of Event:Set up Time: AM/PMEvent Start Time: AM/PM Time of Event:Event End Time: AM/PMClean-up Time: AM/PM Is this meeting ongoing? Yes If so, how often? Weekly Monthly Other Will there be a guest speaker(s)? Yes No Name(s) of proposed speakers (please attach bios):Accepted file types: doc, pdf, Max. file size: 768 MB.List name(s) of proposed topic: PLEASE READ THE REVERSE SIDE FOR REGULATIONS PRIOR TO SIGNING Setup RequestYou may determine the set up for your activity or event. The number of attendees might affect the chosen setup so please provide as accurate of those in attendance as possible Equipment Request Available EquipmentTables (enter amount) Chairs (enter amount) Sound System (enter amount) Microphones (enter amount) Overhead Projector (enter amount) HDMI cords (enter amount) Screen (enter amount) Utility / Facility Request Form Name Untitled Member Non-Member Contact phone:HomeCellDay/Work (Provide the best phone number to call and the time to call) Email Address Secondary contact Name Phone # Type of Event:Date of Event: Estimated Number of Attendees: (This will determine your space)Time of Event:Set up Time: AM/PMEvent Start Time: AM/PM Time of Event:Event End Time: AM/PMClean-up Time: AM/PM Is this meeting ongoing? Yes If so, how often? Weekly Monthly Other Will there be a guest speaker(s)? Yes No Name(s) of proposed speakers (please attach bios):Accepted file types: doc, pdf, Max. file size: 768 MB.List name(s) of proposed topic: PLEASE READ THE REVERSE SIDE FOR REGULATIONS PRIOR TO SIGNING Setup RequestYou may determine the set up for your activity or event. The number of attendees might affect the chosen setup so please provide as accurate of those in attendance as possible Equipment Request Available EquipmentTables (enter amount) Chairs (enter amount) Sound System (enter amount) Microphones (enter amount) Overhead Projector (enter amount) HDMI cords (enter amount) Screen (enter amount)
