Facilities Use Request - External Clients - Conference & Events Services

Today's Date:

Event Details

Event Date

Month

Day

Year

Duration of Event:

Single day.

Repeating (e.g., one Monday every month).

Multi-day (e.g., three days long). Please provide additional dates:

Location of Event Flint - Main Campus
Clio - Northern Tier Center
Fenton - Southern Lakes Branch Center
Lapeer Extension Center

Additional Details:

Event Name:

How many attendees?

Facility Access Time:

Hour

Minute

am/pm

Event Start Time:

Hour

Minute

am/pm

Event End Time:

Hour

Minute

am/pm

Facility Exit Time:

Hour

Minute

am/pm

Room Organization

Room Setup:

Tables in U-Shape

Standard classroom configuration

Other(Please Specify)

Please indicate how many of the following items your event will require.

Easels

Podium

Registration Tables

Chairs for registration tables

Other items? (Please Specify)

Food Services

Will your event require food service? (Only available at Flint - Main Campus) Yes No

If "YES":

Review the Established Catering Vendors.
Contact the Events Office at (810) 232-9636 if you have food related questions.

Next, please indicate the time food is to be served, type of table coverings if desired, menu selection(s) and any dietary requirements (e.g., food allergies, vegetarians, etc.) in the areas below:

Breakfast

Time:

Table Coverings:

Menu choices:

Lunch

Time:

Table Coverings:

Menu choices:

Dinner

Time:

Table Coverings:

Menu choices:

Drink Service

Time:

Table Coverings:

Menu choices:

Snack Service

Time:

Table Coverings:

Menu choices:

** If you have different specifications (e.g., your multi-day event requires serving schedules to vary across days) then please contact the Events Office at (810) 762-0475.

Other food related requirements or restrictions: (Please specify)

Organization Details

Name of Organization?

Type of Organization. Non-profit
For-profit

Do you have a Certificate of Liability Insurance? Already provided to the Events Office
Will send to the Events Office

Contact Information

Contact person

Work Telephone

Cell Phone

Address:

Street

City

State

Zip Code

Email Address

Representative Attending

Please enter details for the organizational representative attending the event if different from above.

Representative

Work Telephone

Attending Representative's Cell Phone Number

Address:

Street

City

State

Zip Code

Email Address

Billing Details

Please enter the billing name and address if different from above.

Name:

Work Telephone

Cell Phone

Address:

Street

City

State

Zip Code

Email Address