Today's Date:    Contact Person:

Name of Event:   Event Date Range:

Start Time  End Time:

Set-up Time  Clean-up Time:

You may be asked to submit a room diagram for set up purposes.

Provide an email address that you may be reachable at for more info.

Daytime Phone

Door(s) Needed Unlocked: South Entrance  North Entrance  E5  E6

Set-up Equipment

Tables       Heat/Air   Stage

Chairs       Lights   Other

Garbage Cans       Doors   Other

Audio Visual Equipment

Podium      Easel   White Board Overhead     Screen    

Video Projector     TV/VCR  

Sound Sys  DVD/VCR

  CD Player  

Ext. Cords

 CD Player/sound system  

   Microphones   Other

Paper Supplies(Quantity)

Lrg. Plates      Knives   Napkins

Cups      Forks   Trash Bags

Bowls     Spoons   Napkins

Dessert Plates      Paper Towles   Other

Paper Supplies Will Be Picked Up Date/Location