| Customer Information |
| Name of Organization
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* |
| Name of person making reservation
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* |
| Title |
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| Phone |
Cell Phone |
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* |
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| Event Information |
| Event Title |
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* |
| Expected Attendance |
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* |
| Description of Event/Planned Activities
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Is this event being co-sponsored? |
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| Are you charging admission, registration fee, or collecting cash donations? (If yes, there will be a room charge). |
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| Are you selling any items or services, or conducting a fundraiser? |
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| Will you invite or are you planning to have off-campus attendees? |
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If yes, whom:
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| Will your event involve music, singing, or amplified sound? |
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Will your event need audio visual support?
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| If audio-visual equipment or a special room set-up is needed, arrangements must be made with the UC Administration Office at least three (3) business days before the event. |
| Will you be serving food? |
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| Comments/Questions: |
Use this section to include any extra information about your event.
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| Dates and Times |
| Rooms assigned after 9:00 p.m. or on weekends will be limited to the UC whenever possible. Rooms cannot be reserved during periods when University classes are not in session (e.g. Winter break, Thanksgiving, etc..) |
| Event Start Date * |
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| Event End Date (Use only if your event runs for more than 1 day) |
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| Event Start Time *
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AM
PM |
| Event End Time *
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AM
PM |
| Is this a repeating event?
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Yes
No |
If yes, how often will it repeat?
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| Single events that require more than 12 hours of reserved space will not be confirmed until the student group/organization has met with a University Center Administration Representative. |
| Room Preferred |
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| Furniture Arrangement Needed |
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| Billing Information |
| Organizations Project/Grant Number
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* |
| Conditions & Liabilities Important: please read |
I agree to abide by the University Center policies. For liability purposes, I agree to ensure that members and guests of the sponsoring organization will not move or tamper with any furnishings or equipment, including tables and chairs. I further understand that all facilities and equipment are subject to availability. I will be responsible for submitting any necessary forms or information to the UC Administrative Office by the dates specified on my Room Confirmation and understand that failure to do so may result in cancellation or charges to my reservation. I understand that my copy of this completed form does not represent a confirmed reservation. Misrepresentation of the nature of the activity, or failure to fully disclose pertinent details regarding this event, may result in additional charges or denial of future facility use.
I understand that this room/table cannot be used by off-campus vendors/individuals under this reservation. I also certify that the information contained on this sheet is correct.
I understand that it is the responsibility of the organization to restore the room(s) to the original condition or a clean-up fee will be assessed.
To agree to the terms listed above please type in your unique name (beginning of UM-Dearborn e-mail address) |
|
@umd.umich.edu* |
