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: