University Facilities Event Support Request Form 

Please use this form when requesting support services from University Facilities for your special event.  
Support services include table & chair rental, custodial and/or grounds services or mechanical support
from our electrical, carpentry, or plumbing divisions.

Contact & Billing Information
Requestor's Name:
Requestor's Phone #:		Extension:
Alternate Phone #:		Extension:
Requestor's Fax #:
Requestor's Department:
Requestor's Email Address:
Event Overview
Event Title:*	Event Date:*
Event Location:*	Campus:*
Event Start Time:*	Event Finish Time:*
Set-up Date:	Set-up Time:
Breakdown Date:	Breakdown Time:
Inclement Weather Date (if applicable)	Inclement Weather Location (if applicable)
Describe your event:
How many people are you expecting?
Will food be served? Please describe:
Have you rented equipment from a non-university supplier? Please describe:
When will non-university equipment be delivered and set-up?
Facilities Support Service Requested
Ground coverage (includes supplemental trash container distribution, cleanup during event and after event)	Yes    No
Custodial coverage (includes cleanup during event and after event)	Yes    No
Electrical, Carpentry or Plumbing or other trade support requested	Describe the type of service you require
What rental equipment do you need?	Quantity
8’  folding rectangular tables
Folding Chairs
3 ‘ concrete footed stanchions
8’  wooden base stanchions
Chrome stanchion with red velvet ropes
Trash containers
Recycling containers
Podium with microphone
Portable sound system with CD recorder & microphone stands
Extension Cords
Portable roadside sandwich boards
Traffic Barricades (saw-horses)
Floor Fans
Responsible Party receiving & signing for Facilities equipment:	Name:
	Phone Number:
Any additional requests?	describe your additional requests here