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Civic Engagement
Meeting Space Request Form
Contact Information
Name of Organization
Contact Person
Address
(Street Address Line 1)
(Street Address Line 2)
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
(City)
(State)
(Zip Code)
Phone
Fax
Email
Program Information
Name/Purpose
of Program
Date of Program
(MM/DD/YYYY)
Time of Program
1:00
1:30
2:00
2:30
3:00
3:30
4:00
4:30
5:00
5:30
6:00
6:30
7:00
7:30
8:00
8:30
9:00
9:30
10:00
10:30
11:00
11:30
12:00
12:30
AM
PM
Amount of Time Needed
hours
Anticipated Attendance
Facility Requested
Veterans Memorial Hall (Room 201)
Martin Luther King, Jr. Room (Room 213)
Presidential Conference Room (Room 207)
Cafeteria
Commons Dining Hall (2nd & 3rd levels)
Alumni Plaza (outdoor brick space)
Main Stage Theater
Callan (Black Box Theater)
Café
Recital Hall
CC 131
CC 225
Open to the Public
Yes
No
By Invitation
Yes
No
Price for Admission
$
Enter $0 for Free
Food Requirements
Breakfast
Lunch
Dinner
Snacks
Equipment/AV Needs
Setup
Notes
How did you
hear about us?
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