Faculty Handbook

Facilities Reservation Form

       
Room Reservation No._________
Instructions: Please print clearly or type- all copies must be legible. Mail completed form to: WCSU, Events Office, 181 White Street, Danbury, CT 06810 or fax to 203-837-8778. Questions? Call 203- 837-8800
A
  1. All reservations and related requests are tentative until confirmed in writing. This also applies to any reservation changes. Cancellations and reservation changes must be made at least 48 hours in advance. A non-refundable deposit of $50 is due upon application. E-mail your requests to events@wcsu.edu.
  2. Reservations will be billed after the event. In addition, there may be additional charges for food service, extra staffing, maintainance, media equipment, etc.
  3. Normally, all events scheduled Sunday through Thursday evenings should plan to end by 12:00 midnight; all events scheduled on Friday or Saturday nights; by 1:00am.
B Name of event or activity:___________________________________________________________________________________
Relationship to WCSU   Student   Faculty/Administration   Club/Organization   Other__________________
Type of Activity   Lecture   Meeting   Concert   Reception
    Dance   Other________________      
         
Building and Room Requesting:______________________________ Day(s) and Date(s) Requested:_____________________
Event Start Time:______   PM   AM Event End Time_____   AM   PM
Expected Attendance__________ Open to the public   Yes   No
Will money be charged?   Yes   No, If yes, how much? ________
Will food be served?   Yes   No (All catering must be done through Dining Services - 203-837- 8755)
Are you requesting to serve alcohol?   Yes   No (student clubs and organizations must get approval
        from the director of Student Center/Student life)
Name of club or organization_________________________________________________________________________________
Name of organization representative__________________________ Title/ Position with organization_____________________
      Email__________________________________________
Address:________________________________________________ Phone Number: Day _______________________
        Evening____________________
C SETUP
Please use back for additional setup		 Additional Staffing
The sponsoring organization may request 		Media Services
203-837-8760
  Round Table QTY:_______ additional staffing for an event or the event may See planning guide for additional
  Rectangular Tables QTY:_______ require additional staffing. equipment and charges.
  Chairs QTY:_______      
  Podium QTY:_______   Maintainance _____hr X $ _______________   Overhead Projector $_____
  Other     Police $ _______________   Screen $_____
      Stage Manager $ _______________   VCR/TV Monitor $_____
________________________________   Music Dept. Fees $ _______________   Camcorder $_____
      Facility Rental Fees $ _______________   Other $_____
________________________________   Piano Tuning $ _______________ Total media fees charged $_____
      Audio $ _______________   LCD Projector  
________________________________
Less Deposit
 $ _______________ (Contact UC at 203-837-8467)
    Total Fees Charged $ _______________ GRAND TOTAL $_____
D I have read the above and agree to abide by these statements. I understand that this reservation is confirmed only upon reciept of the approved confirmation copy. The individual who signs this contract warrants that he/she is legally authorized to execute this contract for the organization or club.
________________________________________________________ __________________________________________________
Authorized Representative (Print Name)   Authorized Signature
Date
         
   
Clubs & Organizations
  
         
________________________________________________________ __________________________________________________
Faculty Advisor (Print Name)   Faculty Advisor Signature
Date
E          
_______________________________________________________ __________________________________________________
Coordinator of University Events Signature
Date
 Witnessed by
Date

 

 


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