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Building Use Request Form
Home
Building Use Request Form
Building Use Request Form
Jeff Harris
2017-01-22T19:09:35-07:00
This form is to be used for all event requests 2 weeks in advance.
Burrell College of Osteopathic Medicine Building Use Request
Is this a Burrell College Student Group Request?
*
Yes
No
Event Name
*
Type of Event
*
Conference
Meeting
Presentation
Tour
Event Description
*
Contact Name
*
First
Last
Contact Email
*
Contact Phone Number
*
Contact Organization
*
Event Date
*
MM slash DD slash YYYY
Event Start Time
*
:
Hours
Minutes
AM
PM
Event End Time
*
:
Hours
Minutes
AM
PM
Will this event have a guest speaker from outside of Burrell College?
Yes
No
To accompany the event request, a
guest speaker request form
must be filled out for approval and submitted to the Office of Student Affairs. You may continue to complete the Student Organization Event request form.
Estimated Number of Attendees
*
Expected Attendees
*
Select All that Apply (Ctrl Click to Highlight Multiple)
Burrell College Faculty/Staff
Burrell College Students
Guests under 18 years old
Other individuals not associated with Burrell College - please provide details below
Other Attendees
Where will this event take place?
Burrell College Campus
Off-Campus
Rooms Requested
*
Select All that Apply (Ctrl Click to Highlight Multiple)
Not Applicable (Please explain in Setup section)
Any Lecture Hall (200 Max)
Any Seminar Room (25-50 Max)
Any Conference Room (4-12 Max)
Room 111 (Small Conference Room)
Room 112 (Large Conference Room)
Room 128 (Large Conference Room)
Room 147 (Bear Den)
Room 151 (Seminar Room)
Room 152 (Seminar Room)
Room 153 (Seminar Room)
Room 154 (Student Lounge)
Room 155 (Seminar Room)
Room 156 (Seminar Room)
Room 157 (Seminar Room)
Room 158 (Year 2 Lecture Hall)
Room 160 (Year 1 Lecture Hall)
Room 204 (Seminar Room)
Room 306 (Board Room)
Outdoor Space (Courtyard)
Room Configuration Requested
*
Traditional Classroom Style - All Seats Face Towards Presenter
U-Shaped Boardroom Style - Tables arranged in a U with the opening towards the presenter
Conference Room Style - Tables arranged to form a central large table
Group Pods Style - Tables arranged to form small pods around the room
Other (Please describe in Setup section)
Setup
If additional time is required for event set up and tear-down, please fill out the following.
Setup Start Time
:
Hours
Minutes
AM
PM
Setup End Time
:
Hours
Minutes
AM
PM
Special Requests/Requirements/Other Needs (e.g. PR needs)
Will Refreshments be Served?
*
Yes
No
Audio Visual Support Requests
All Burrell College meeting rooms have at a minimum a large format TV monitor with a wireless connection system which will accommodate most presenter laptops. While this system is suitable for most presentations – it may not support high definition video. Additional support / capabilities are available if needed. Please describe any additional requirements below. If presenter is using a Mac, some additional support may be required, so please indicate that as well.
Would you like your event advertised on digital tv signage?
Yes
No
Do you have your own Digital Signage image to submit, or would you like one to be created for you?
Submit
Created
Please include the details (Time, Date, Contact Information, etc) you would like featured on the Digital Signage:
Digital Signage Submissions:
Drop files here or
Select files
Accepted file types: jpg, pdf, png, gif, psd, aippt, Max. file size: 20 MB.
Image must a ratio of 16:9, and a resolution of at least 1280x720. If you have the working file, please submit that, Burrell College reserves the right to make changes to the submitted file .
X
X
