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QCC Facility Request Reservation Form

All fields MUST be filled out prior to submitting this request. YOU MAY NOT SUBMIT MORE THAN 3 EVENT REQUESTS PER DAY.

Please review the Use of Campus Facilities policy and purpose prior to completing this form.

Today's Date*

Date of Event (mm/dd/yyyy)*

Day of Event*

choose a day from the drop-down menu

Purpose for Event (include description)*

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*

Enter only ONE email address. You will receive an email confirmation which can be forwarded to other interested persons

Phone*

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).

Other space

Enter the desired location

Absolutely NO food is permitted in this space. Classroom must be fully restored after use.

Number Attending*

The name of the Faculty/Staff Member who will be in attendance at this event (1 name):*

Open to Public*

Yes No

Food to be Served*

Yes No

Please confirm that you understand it is your responsibility to notify Security directly of your event:*

I agree

Please confirm that you understand it is your responsibility to notify B&G directly of any needs you have relating to this event:*

I agree

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.