Application for Use of University General Purpose Classrooms and Auditoriums

Name of Organization:

Proposed activity (be specific):

Number of people expected:

Room Choices - Please list choices in order of preference (more than one room number per field may be entered). Only one room will be assigned unless multiple rooms are requested in the comments field. Other rooms may be substituted if the preferred rooms are uavailable.

Room choice 1:	Room choice 2:	Room choice 3:

Are you requesting (choose one option only):
semester-long reservations (e.g., every Wednesday from 8/31/05 through 12/7/05)
All other reservations/individual dates

Reservation Times:
From: Hour : Min: AM/PM:
Until: Hour: Min: AM/PM:

OFF CAMPUS SPEAKER:
Do you plan to present an off campus speaker?
Yes No

LITERATURE AND SIGNS:
Do you plan to post signs on kiosks around campus?
Yes No
If yes, be sure your organization complies with guidelines outlined in "Information Sheet for Posting Signs"

Do you plan to distribute petitions, handbills, or literature?
Yes No

SPONSORSHIP AND SOLICITATION:
Is this activity solely sponsored by the organization/applicant?
Yes No

Do you plan to collect any money?
Yes No

Do you plan the distribution of food and/or drink?
Yes No

Comments:

Name of Authorized Representative:
(Must be an authorized representative in order to apply.)

Phone Number:

Email:

You will receive a confirmation from our office when this form is processed.

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