EmailMe Form - Facilities Rental Request Form

Name of Organization or Group *

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Contact Person *

First Last

Contact Phone *

### - ### - ####

Contact Email *

Type of Organization *

Date of Event *

MM / DD / YYYY

Start Time of Event

HH : MM AM/PM

End Time of Event

HH : MM AM/PM

Building Name or Number

Room Requested

Campus Location *

Brief Description of Event

Number Expected *