Student Club Info

Campus Activity Request Form

Name of Person Completing Form

Name of Primary Contact for this event

Club Name

If you are not a club, please leave blank.

Club Advisor Name

Name of Activity

Date of Activity

Start Time – End Time

ON or OFF Campus

Campus Location

Do you require any additional equipment

(YES or NO)

If yes what will you need?

(ie- number of extra chairs, tables, a podium, microphone, projector, etc.)

On Site Faculty/Staff Name

On Site Faculty/Staff Cell Phone

Other Description

Who is cleaning up afterwards?

*Note: All facilities need to be left the way they were found, so please return everything to its original location.

Flyer Attachment

Max. file size: 50 MB.

50+

Degrees and Certificates