Facility Reservation Form Contact Person* First Last Sponsoring Organization* Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*(XXX) XXX - XXXXEmail* Event InformationFacility Requested* Program Room Conference Room (Lactation Room) Multipurpose Room Name of Event* Event Type*MeetingClassLecturePerformanceOtherIs this a one-time event?* Yes No Meeting Recurrence* Weekly Bi-Weekly Monthly One-time event Day(s) of the Week* Monday Tuesday Wednesday Thursday Friday Date of Event* MM slash DD slash YYYY Beginning Date* MM slash DD slash YYYY Ending Date* MM slash DD slash YYYY Start Time* : Hours Minutes AM PM AM/PM End Time* : AM PM AM/PM Set-Up Time : AM PM AM/PM Estimated Attendance*What is the purpose of your group/event and how does this support the mission of the Women's Center?*Audio Visual Request Monitor Laptop Easel* Other *We do not provide flip chart paper or markersSpecial InstructionsReservation of Women's Center requires applicants to read and agree to the policies and accept responsibility during the above events, which includes, but is not limited to:The Women's Center reserves the right to determIne the appropriate use of our facilities. Reservations for space are group or event specific, and may be changed only by the Women's Center staff. Responsibility for setting up the furniture in the room and ensuring the room is cleaned up and returned to its original condition at the end of the event. No tape, nails, staples, etc. may be used on facility walls, ceilings, or windows. Responsibility for damage to any Women's Center furnishings or equipment used and any damages to the meeting space itself (furniture, walls, etc.) The Women's Center does not provide any supplies (i.e., markers, flip charts, plates, cups, etc.) or technical support for any of the AV equipment. No unauthorized use of Women's Center equipment or supplies (e.g., computers, copier, fax machine, etc.) is permitted. All catering arrangements are to be made by the reserving organization, according to University policy. The Women's Center is not responsible for food distributed and provided by other organizations using the space. The kitchen is only to be used to prepare refreshments, which involve no cooking, only warming. Individuals or groups utilizing the kitchen facilities must provide their own supplies.Do you accept the reservation policies?* I Accept CommentsThis field is for validation purposes and should be left unchanged.