Conferencing & Event Services  

Room & Event Request Form

*Required Field
Your Information
Requestor's Name (First & Last):*
Requestor's Phone Number:* Requestor's AQ Email Address:*
Name of AQ Department/Registered Student Organization:*

Event Information
Event Name:* Event Date:*
Event Time:
Start:* Finish: Arrival time of program participants:
Venue access time (if earlier than event time):
Preferred Location:
First Choice:* Second Choice:
Number of Attendees:
On campus: Off campus:
Event Format:
Reception & Dinner Dinner Lecture Meeting Other:
Budget Number: Split Budget:
Please provide a budget number, NOT the department name.
RSVPs collected by: Host Department Event Manager RVSP Not Required
Host Department (AQ Department Hosting Event):
Host Department/Event Contact Person:
Name (First & Last): AQ Email Address: Phone Number:
Registered Student Organizations ONLY:
Advisor's Name (First & Last): Advisor's AQ Email Address:
Advisor's Phone Number:    
Is catering required for this event? Yes No
Additional comments:
Note: If print materials are needed for the event, please contact Graphic Design Services in the AQ Media Center.
Image Verification
Please enter the characters you see in the image: