Today's Date: Person making this request: E-mail Address: Campus Address: Campus Phone:
Home Address: Home Phone: Area requested for use: (Please check all that apply) Lobby Area Field House 105 Martial Arts Room 150 Court #1 Multi-Purpose Room Court #2 Aerobics Studio Room 101 Court #3 Climbing Wall Court #4 Indoor Track Other
Event Information: Date of Event: Name of Event: Sponsoring Organization: Co-Sponsoring Organization:
Faculty representative present during the event: Is this a fundraiser? Yes No If yes, has it been approved through university relations: Yes No Not applicable
Will an admission fee be charged? Yes No
Will non-UW-L students be participating? Yes No
Event Start Time: Event End Time:
Set Up Time: Clean Up Time:
Will food be served? Yes No Chartwells must be used, no outside vendors!
SPECIAL EVENTS OR ARRANGEMENTS: Please include ALL needs for this event. This office does NOT schedule audio-visual equipment.
SET UP NEEDS EQUIPMENT NEEDS:
Please indicate in this area the items and the quantity of each that you will need for your event. Be very specific on this request.
Please provide a hard copy version of any diagrams that show special set up requirements.
NOTE: This is only a request! You will be notified by e-mail concerning the status of your request.
Thank You
