Phone number of Responsible Party/Contact Person: *
Your answer
Email of Responsible Party/Contact Person: *
Your answer
Are you an active participant at UUCC (i.e. a member, contributing friend, or regular attender)? *
Date of Requested Use *
MM
/
DD
/
YYYY
Start time (time you need to enter the building, be sure to include time to set-up if necessary): *
Time
:
AM
PM
End time (time you will exit the building, be sure to include time for clean-up) *
Time
:
AM
PM
Is this a recurring event or a one time event? *
If it is a recurring event, how often will the event happen (i.e. the third Tuesday of every month)?
Your answer
Estimated number of participants: *
Your answer
Are you providing childcare? *
Is there a charge to attend? *
Is the event open to the public? *
Areas requested (check all that apply) *
Required
Is AV equipment required (microphones, projector, etc)? If yes, please specify needs. Please be aware that there is an additional fee for UUCC to provide a Sound/AV Tech for your event. *
Your answer
Have you reviewed and do you agree with UUCC's "Guidelines for Use of Facilities"? *