Judson University

  Event Name

  Event Purpose

  Expected Attendance

  Facility Requested

Month January February March April May June July August September October November December     Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31    Year 2012 2013 2014  Date of Event Start

Month January February March April May June July August September October November December      Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31     Year 2012 2013 2014  Date of Event End

select 12:00 12:30 1:00 1:30 2:00 2:30 3:00 3:30 4:00 4:30 5:00 5:30 6:00 6:30 7:00 7:30 8:00 8:30 9:00 9:30 10:00 10:30 11:00 11:30 A.M. P.M.     select 12:00 12:30 1:00 1:30 2:00 2:30 3:00 3:30 4:00 4:30 5:00 5:30 6:00 6:30 7:00 7:30 8:00 8:30 9:00 9:30 10:00 10:30 11:00 11:30 A.M. P.M.  Set-up Time (Start and Finish)

select 12:00 12:30 1:00 1:30 2:00 2:30 3:00 3:30 4:00 4:30 5:00 5:30 6:00 6:30 7:00 7:30 8:00 8:30 9:00 9:30 10:00 10:30 11:00 11:30 A.M. P.M.     select 12:00 12:30 1:00 1:30 2:00 2:30 3:00 3:30 4:00 4:30 5:00 5:30 6:00 6:30 7:00 7:30 8:00 8:30 9:00 9:30 10:00 10:30 11:00 11:30 A.M. P.M.  Event Time (Start and Finish)

CONTACT INFORMATION

 Name

 Phone Number

Email Address

Person or Group Sponsoring Event

 Phone Number of Sponsor

Please indicate below all special needs and arrangements (in detail) to be provided by Judson University.

Please feel free to sketch and fax any special floor plans or arrangements to 847-628-2028. Include name, date, and time of event.

 Chairs Needed

 Tables Needed

Please check all that apply:

 Dining Service Support Requested

Indicate Specific Dining Service Needs Here.  

 Audio Visual/Technology Equipment Requested

Indicate Specific Audio Visual/Technology Needs Here.   

Audio Visual/Technology Staff Support Requested

NOTE: By checking this box, you hereby acknowledge that you have obtained prior approval from Information Technology to provide staff to support your event.

 Indicate Specific Audio Visual/Technology Staff Support Needs Here.  

 Plant Operations Support Requested

Indicate Specific Plant Operations Needs Here.  

 Campus Safety Support Requested

Indicate Specific Campus Safety Needs Here.  

General Questions, Comments or Suggestions?

Indicate General Needs, Questions, and Comments Here   

IMPORTANT NOTICE:
No facility is reserved without a proper request form being submitted. Please do not assume that a facility is reserved until confirmation has been received.

BEFORE YOU SUBMIT THIS REQUEST:
By clicking "Submit Form", I hearby affirm that I clearly understand that I have full responsibility for use of the requested facility. I further certify that facilities used will not conflict with the Conference Services Manual.