UConn-Waterbury Campus Event Request Form UConn-Waterbury Campus Event Request.ASG This form is to be submitted for any student organization sponsored/co-sponsored/hosted meeting/event/program happening on/off campus, regardless of audience/participation. Once submitted, the student leader planning this event should schedule an appointment to review this with the Student Activities Coordinator. Submission of this form does not indicate approval of the event, confirmation of funding, or on campus space use. Student leaders must follow up accordingly to insure confirmation of funding and space reservations. Event/Program Registration InformationStudent Organization Sponsoring Event/Meeting (no acronyms please)*Student Leader Name* First Last Officer Title*Officer Email*Phone Number*Faculty/Staff Advisor Name* First Last This is the individual who has agreed to serve as your official club advisor.Faculty NotificationHave you informed your advisor of this event?Faculty AttendanceWill your advisor be in attenance?Organization's Faculty/Staff Advisor EmailWe are planning*A club meetingAn event on campusAn event off-campusGeneral Description of Event/ProgramName of Event/Program*Date of Event/Program* Date Format: MM slash DD slash YYYY Start Time* : HH MM AM PM End Time* : HH MM AM PM Who Will be the Faculty/Staff Person at the Event/Program?*This would only be for non-meeting events/programs.Will Your Event/Meeting Repeat?*YesNoDescribe the Meeting/Event*Who will be attending the event/program (check all that apply)* Select All My organization's members Other UConn students UConn faculty/staff General public Other Estimated Attenance*On-Campus Space RequestPlease provide the following information for an event/program on-campus. Requests for space requires a minimum of TWO WEEKS notice. Submitting this form does not guarantee space availability. You must also meet and review your event/program requirements with the Student Activities Coordinator to confirm your use of space.Preferred Location*Room 102Room 113Room 116MPR 113-116-1194th Floor WRECFront HallwayCourtyardWill You Need Additional Time to Set-Up?*YesNoSet-Up Description*Briefly describe how you will need the space set-up (include number of tables, chairs, audio-visual, etc.). You must meet and discuss specifics with the Student Activities Coordinator.AV Set-Up Needs (check all that apply)* DVD Player Microphone and Microphone Stand Hand Held Microphone Projector Computer/Laptop None Other Budget & Financial InformationAll funding proposals through ASG require a MINIMUM of two weeks advance notice. Funding approvals must be reviewed by ASG before any expenses are confirmed. Events requiring contracts, advance ticket sales, and new vendors may require additional time to process. Information submitted on this form is not a guarantee of funding. Any questions regarding the approval process should be directed to ASG.Do You Have ASG Funding for the Event/Program?*YesNoIf You Have Other Sources of Income, Please DescribeWill You Be Selling Tickets for this Event/Program?*YesNoIs This a Fundraising Event/Program?*YesNoContractsStudent organization leaders should not be signing contracts that are to be paid using University or ASG funds. To assist you with facilitating this process, please provide general information regarding the companies/individuals/organizations you may be utilizing for your event/program.Will Your Organization be Entering into Contractual Agreements?*YesNoIf "Yes," to "Contractual Agreements," Please Provide DetailsFood & Beverage InformationWill Food/Beverages be Provided at the Event/Program?*YesNoIf "Yes" to Having Food/Beverages, please give detailsWill Alcohol be Present at the Event/Program?YesNoAdditional informationWill Anyone Under 18 be Participating in the Event/Program?YesNoThis does not include currently enrolled UConn students that may be under the age of 18.Are You Required to Provide Security?YesNoSecurity can be public or private and could include police, private firm, etc. Submissions with less than two week's notice will not be considered. Events with contracts, new vendors, and other considerations may require 4-6 weeks advance notice. There is no guarantee of on-campus space, funding, or other resources that are required for this event/program. A meeting will be set-up with the Student Activities Coordinator to review this event/program and any applicable laws, policies, and best practices related to our planned activity. As the student leader, I will follow up as needed to properly plan and execute this event.