Event Request Form

Event Date*

Event Title*

Event Time

Set Up Start Time*

: HH

MM

Set Up End Time*

: HH

MM

Event Start Time*

: HH

MM

Event End Time*

: HH

MM

Clean Up Start Time*

: HH

MM

Clean Up End Time*

: HH

MM

Event Occurance*

One time event
Reoccuring

Department/Club*

Point of Contact

Name*

First Last

Phone*

Email*

Are there expenses associated with this event?*

No
Yes

Event Budget*

Please attach the itemized list of expenses.*

Will food be served at the event?*

No
Yes

Venue*

Type of Event*

Attendees*

Student
Alumni
Outside Guests
Staff/Faculty
Other

Other Attendees*

Expected Number of Attendees

Total Participants*

Volunteers*

No
Yes

Enter expected number of volunteers*

Staff*

No
Yes

Enter expected number of staff*

Purpose of Event*

(What is the end goal of hosting this event?)

Brief Description*

(Information will be used for FXUA calendar and announcements)

Speaker

Do you have an external speaker coming in?*

No
Yes

(If yes, please attach a brief bio and photo of the speaker)

Name*

First Last

Phone*

Email*

Please upload a bio and a photo of the speaker*

Drop files here or

Media Requests

Lecture Video
Photographer
A/V Sound
Lapel Microphone
Handheld Microphone
Backdrop
Sound System Support
NA
Other

Please specify*

Promotion Requests

FXUA Homepage Calendar
Weekly Email Announcement to Students
FXUA Blog
FXUA FB Page
Outside Signage
Other

Check desired advertising and attach documents respectively.

Please Specify*

Upload Document*

Drop files here or

IT Requests*

Extension Cords
Projector
Laptop
NA
Other

Capabilities depend on venue.

Please Specify*

Extension Cords Quantity*

Property Management Requests
Capabilities depend on venue.

Room Arrangement*

How many total chairs does your room arrangement require?*

Transportation

Does your event require shuttle service?*

Yes
No

From*

: HH

MM

(Time Window)

To*

: HH

MM

(Time Window)

Pick up at*

Street Address Address Line 2 City State ZIP Code

Drop off at*

Street Address Address Line 2 City State ZIP Code

Special Notes to CAB

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