Club event request form

Name of Club:

Date of Request:

Event Leader:

Advisor:

Phone Number:

E-Mail Address:

Event Title:

Date of Activity:

Preferred Location:

Start Time:

End Time:

Event Description:

Please be very specific and include complete titles and names of any film, DVD, presentation, performer etc. and describe what will happen at the event.

Web Site or Link with more information:

By submitting this form I am acting for the above named club and should this event be approved we agree to accept responsibility for any fees and charges from the use of the College's facilities. The club agrees to follow all of the College rules and regulations.