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OFFICE OF SPECIAL EVENTS AND SPACE RESERVATIONS

SPACE REQUEST FORM

Note: This application will only be processed when all applicable documentation is submitted. Requests will be reviewed in the order that they are received. All rooms are reserved on a first-come; first-served basis; however, submission of this application does not guarantee reservation of space. An email confirmation will be sent from the Office of Space Reservations. * All internal requests MUST be submitted a minimum of 14 business days in advance of the event.* All external or University affiliated requests MUST be submitted a minimum of 21 business days in advance of the event.

Today’s Date:

1. Contact Information:

Name of Requester/Organization:

Contact Person: Title: ______________________

Address:

City: State: Zip Code:

Phone ( )_ Cell ( )_ Email

2. Title of event

3. Event/Program Description:_

4. Event Date: 1st

Choice: _____/ ___ / 2nd

Choice: / _ / 2nd

Choice: / _ / _

5. Anticipated Attendance: __________

6.

7. Desired Location(s) and capacities:

MAIN CAMPUS STUDENT CENTER SCHOOL OF LAW

Theater of the Arts (900) Ballroom (Entire: 300-400)

Windows Lounge (95) Ballroom A (150-250)

Building 44, Room A03 (100) Ballroom B (100-150)

Building 42, Room A06 (60) Heritage Hall (200-250)

Seminar Room 509 (28)

Classroom 515 (110)

Classroom 516 (110)

Moot Courtroom (130)

Dennard Plaza (2500) Tower Conference Room (14) OTHER

Sports Complex (3000) Exec. Conference Room (15)

Firebird Inn (125) COMMUNITY COLLEGE

Amphitheatre (250) Bertie Backus Auditorium (330)

Student Cntr. A Level Plaza (60) 801 N. Capitol Multipurpose Room (Full – 160)

Conf. Room 439 (16)

Classroom 505 (90)

Classroom 506 (45)

Seminar Room 507 (28)

Seminar Room 508 (28)

8. Event specifics:

Admission will be charged at door3 Alcohol will be served

23

Money will be exchanged at the venue3 Alcohol will be sold

23

Event will involve minors3 Event will involve political/religious activities

Event is open to the public Event will be catered internally

Event will be catered externally (Caterer’s ame/Contact:________________________________________________________)

Special accommodations required (Please Specify:_____________________________________________________________)

Event will involve high profile attendees3 (Please Specify:________________________________________________________)

1 Clinic use only

2 Alcohol can only be distributed by a licensed caterer, bartender or T.I.P.S trained personnel. Additional contract documentation is required

3 University Police required

Description: Date Start Times End Times Total Hours

Setup/Load-in

Rehearsal (if applicable)

Registration/Pre-event/Reception (if applicable)

Event (Start and End Times)

Post-event/Reception (if applicable)

Breakdown/Load-out

Classroom 334 (42)

Classroom 335 (42)

Seminar Room 326 (8)

Multipurpose Rm 322 (120)

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9. Are vendors going to be a part of your event?

_ Yes _ No Specify Number: ___

10. Support Services:

Round tables (Quantity ) Handheld Mic(s) (Quantity ___) PA System

Rectangular tables (Quantity ) Lapel Mic(s) (Quantity ____) Custodial services1

Chairs (Quantity ) Projector(s) (Quantity ____) University police1

Podium Laptop(s) (Quantity ____) WiFi

Video recording (limited to School of Law 5th

floor rooms)

Catering – Contact Althia Henry, ahenry@perkinsusa.com/202-274-5820

Parking – Contact Senai Simon, senai.simon@uc.edu /202-274-5987

11. Describe specific setup/layout requirements:

12. Please list the names of speakers, artists, performers, and/or principal participants in your program:

13. INSURANCE: User, at its sole cost and expense, will maintain adequate insurance coverage for User, its officers, directors, employees, and agents. The policy shall be endorsed to include the University of the District of Columbia, the UDC Board of Trustees, officers, employees, and agents as additional insured with respect to the use of the University’s facilities by the User to insure against any losses or claims which may arise under this Agreement. Such insurance coverage shall include: a. (i) statutory workers’ compensation and employer’s liability insurance, including disability benefits; b. (ii) comprehensive general liability insurance (including contractual liability coverage, broad form property damage

liability and personal, bodily and advertising injury liability) covering all User’s personnel engaged in the performance of services hereunder, with limits of at least $2,000,000 each occurrence;

c. (iii) professional liability insurance covering User/User’s personnel with a limit of not less than $1,000,000 per occurrence; and

d. (iv) theft and fire insurance (with applicable standard extended coverage clause) for all properties brought into or used in or on University property.

Such insurance will be primary and noncontributory to any insurance maintained by University of DC. User will submit certificates of insurance to University of DC no later than 14 business days in advance of the event. *Insurance requirement coverage is subject to change.

It is hereby agreed upon by the person/organization/presenter requesting the use of a University of the District of Columbia (UDC) facility that no information or publicity of any nature relating to this proposed event may be announced or released in any manner until the standard facility use agreement contract is executed by the UDC Office of Space Reservations and the applicant and the required deposit has been paid. Furthermore, applicant hereby represents that a full, accurate and complete disclosure of all information has been made and that the above statements and information are true and correct.

The representation of applicant contained in this pre-contract application shall survive and be a part of the facility use agreement contract. The user may not assign nor enter into any dual sponsorship agreement unknown to the University of the District of Columbia.

APPLICANT SIGNATURE:

Signature:

Print Name: ______________________ ___________

Title:_ ____

Date Signed: _____ _____________

FOR OFFICIAL USE ONLY

Event Management Approval:

Signature:

Print Name:

Title: _

Date:

Club/Organization Advisor Approval:

(if required)

Signature:

Print Name:

Title: _

Date:

Student Development and Success

Approval (if required):

Signature:

Print Name:

Title: _

Date:

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User may incur additional charges