QCC Facility Request Reservation Form

Notice All fields MUST be filled out prior to submitting this request. YOU MAY NOT SUBMIT MORE THAN 3 EVENT REQUESTS PER DAY.
Today's Date 
Date of Event (mm/dd/yyyy) 
Day of Event 
Purpose for Event 
Start Time 
(Your time in this space MUST include set-up time.)
Actual Event Start Time 
End Time 
(Your time in this space MUST include clean-up time.)
Contact Person 
Email 
Phone Number 
Requesting Department 
Requested Space 

Be advised, if the space you are requesting is not on this list, the Box Office is not the responsible department for that space. For classrooms, lecture halls, etc. please contact Amy Baltajian in the Registrar (ext. 4240).

Number Attending 
Faculty/Staff Member attending this event 
Open to Public   
Food to be Served   
Please confirm that you understand it is your responsibility to notify Security directly of your event: 
Please confirm that you understand it is your responsibility to notify B&G directly of any needs you have relating to this event: 

Prove you’re not a robot

*Math Challenge.

Math Challenge Will Appear Here *Enter Math Answer: 

Note: No requests, neither verbal or through email, shall be honored without receipt of this official form. No form, no reservation.

Your room request is NOT approved until you receive an email confirming your event.