HARRE UNION

UNION ROOM RESERVATION FORM

EVENT INFORMATION
Name of Event:
Sponsor:
Date(s) of Event*:
Alternate Date(s)*:
*if event is a recurring event, put all dates in the box. You do not have to submit multiple requests.
Event Start Time:
Event End Time:

What time would you like the room setup by?
(to decorate, rehearse, etc.)
Expected Attendance:
   
Name of Requestor: (required)
Requestor Email: (required)
Requestor Status:
Phone: (required)
Alternate Phone/Fax: (please specify phone or fax)
Advisor:
Food:


FACILITY INFORMATION
Building:

Room(s) desired:
(Please list in order of preference.)
Room Setup:
Additional Setup Instructions/Comments:
Audio/Visual Equipment:
(specify quantities in "Other")




Lectern
Microphone(s)
LCD Projector (will bring own laptop)
Computer w/PowerPoint
Computer w/Internet
DVD/VCR
Overhead Projector
Slide Projector
Projection Screen
Dry Erase/Whiteboard
Flipchart and stand
CD Player
Stage (specify size in "Other Instructions")
Stage Lighting (Ballroom only - charge may apply)
Other equipment/instructions:

© 2009 VALPARAISO UNIVERSITY
1700 Chapel Drive, Valparaiso, Indiana 46383-4543 | USA
All Rights Reserved.
University Switchboard phone number: (219) 464.5000, Mon. - Fri. 8 a.m. - 5 p.m. CT
For safety and security issues, call the University Police Department: (219) 464.5430