Application for Unaffiliated Use of VSU Facilities

This facility request form is to be used for off campus users.

Contact Information

User's Name
E-mail:
Today's Date
Home Phone
Day Phone
Organization Name (if different from your name)
Type of Group:	Administrative Department Academic Department Student Organization Campus Organization
Event Coordinator
Home Phone
Day Phone
Address of Organization: Street, City, State, Zip
Please notify me via (check one):	Email Address: Phone Call/ message at phone number: Intercampus Mail. My address is:

Event Information

Event Title (as you would like it posted)
Type of event	Lecture Meeting Exhibit Pageant Banquet Other
Target Audience:	Community Valdosta State University Your Organization Only
Number Attending:
Date Requested:

Pre-Access Time
Start Time
End Time
Post Access Time

First Choice Location:

Second Choice Location: Date Requested:

Pre-Access Time
Start Time
End Time
Post Access Time

*if more than one of the same item is needed, please specify in the Detailed Description area of this form.

Set-Up:

Detailed Description:

Reservation Checklist:

Any further action required for "yes" marked under "requested" must be complete before final authorization will be granted. Example: for an event where the user is a recognized student organization and the event has an admission fee or is a fundraiser, the user also must submit the Fundraising Approval Form available in Event Services.

A RESERVATION IS NOT CONFIRMED UNTIL A CONTRACT HAS BEEN GENERATED AND SIGNED BY BOTH PARTIES.

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Continuing Education	Fine Arts	PE Complex	Pound Hall	Powell Hall
Auditorium	Art Gallery	Arena	Auditorium	Lecture Hall
Lobby	Choral Room	Lobby	Classroom #	Lobby
Classroom #	Lab Theatre	Mezzanine
	Sawyer Theatre	Classroom #
	Whitehead Auditorium
	Classroom #

Science Building	University Center	Classrooms
Auditorium 1011	Cypress Room	Martin Hall #
Auditorium 3009	Dogwood Room	Nevins Hall #
Classroom #	Live Oak Conference Room	West Hall #
	Lobby	UC #
	Magnolia Room (1/2)	Other
	Magnolia Room (1&2)
	Rose Room
	Wisteria Theatre
	Willow Conference Room

Audio	Visual		_________ Other
Lapel Microphone	LCD Projector	Laptop	Tablecloths
Corded Microphone	Slide Projector	TV	Piano
Cordless Microphone	Overhead Projector	VCR	Floor Podium
CD Player	Screen	DVD	Tabletop Podium
	Flip Chart/ Easel	Dry Erase Board

Tables:	Chairs:	Style:
60 inch round	number	U-Shape	Conference
8 ft. x 18 in. testing		Classroom	Banquet
6 ft. x 3 ft. rectangle		Reception	Auditorium

Planned Activities	Requested Yes No	If Yes, Complete the Following:
Will food be served?		Contact Valdosta State University Catering at 259-5510.
Will you require special parking?		Elaborate in the Detailed Description area of this form.
Will sound amplification by required for any aspect of this event?		See Media Services to reserve proper audio visual equipment.
Will there be any fundraising aspects?		Complete Event Services Fundraising Approval Form.
Will you be showing a PowerPoint presentation?		If you will be bringing your own laptop, please specify in the Detailed Description area of this form.