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Facility Scheduling Form

Personal Information

Your Name
Email
Campus Phone
Campus Box

Event Information

Event:
Building:		Room No.:
Date of Event:		Estimated Attendants:
Time of Event:	am pm	Time Event Ends:	am pm
Setup Time:	am pm	Tear Down Time:	am pm
Sponsoring Organization:

Equipment Needed

Fill in the number needed:		Check all that apply: Stage Screen P.A. System Slide Projector Overhead Projector Video & Data Projector Standing Podium (no mic) Standing Podium with Microphone Tabletop Podium (no mic) Tabletop Podium with Microphone TV-VCR TV-DVD Computer (Kilpatrick Only)
# of Tables:
# of Chairs:
# of Food Tables:
# of Entrance Tables:
# of Head Tables:
# of Lapel Microphones
# of Microphones on a Stand
# of Handheld Microphones

Special Instructions?