LCC Request Form

Space Request Form

Organization:
Name/Title of person responsible for event:
Event Name:
Event Description:
Phone:
Email:
Fax:

Day	Date (MM/DD/YY)	Reserved From [time]	Reserved to [time]	Event Begins	Estimated attendance

Room Setup:
Please provide details and any special instructions (provide a diagram if necessary):

Do you have Technical Needs (LCD projector, DVD, etc.):
[ If Yes, then please specify request. For simple needs give 2 weeks advance notice. For complex needs give at least one month notice. ]

Will any food or beverage be served?
If Yes, who will be catering?

NOTE: This request for space is confirmed only when a written confirmation is returned to the applicant.
The organization, it's officers, and any individual applying to reserve space on behalf of the organization are responsible for the condition of the facilities used, clean up and the use to which they are put during the time reserved. The organization and such persons shall be responsible for all damage or misappropriation by any guests, invites, or non-member attendees and shall reimburse UIC and the RCOLCC for any such damages or loss. No organization other than the reserving organization may use the facilities reserved.
Please be advised that there is a possibility of room changes due to RCOLCC events. Should your reservation for space be changed by this office, we will attempt to notify you promptly and aid you in arranging other rooms outside the RCOLCC.

Any event lasting 3 or more hours requires approval of Assistant Director.

I agree with the above terms and conditions