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Organization*

Organization Type*

UW Student
UW Alumni
CERC Affiliated Group
UW Department
Government Agency
Off-Campus Group

Street Address*

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Name of Primary Contact Person*

Title of Primary Contact Person*

Primary Contact Phone*

Primary Contact Email*

Event Information

Event Description*

Schedule By*

Date Range
Individual Days

Event Start Date*

Event End Date*

Start Time*

:

AM/PM

End Time*

:

AM/PM

Day 1*

Day 1 Start Time*

:

AM/PM

Day 1 End Time*

:

AM/PM

Day 2

Day 2 Start Time

:

AM/PM

Day 2 End Time

:

AM/PM

Day 3

Day 3 Start Time

:

AM/PM

Day 3 End Time

:

AM/PM

Day 4

Day 4 Start Time

:

AM/PM

Day 4 End Time

:

AM/PM

If additional dates or times are needed, please note here

Are you charging admission or a registration fee?*

Yes
No

Are you conducting a fundraiser?*

Yes
No

Are you selling good or services?*

Yes
No

Event Details

Room Requested*

ARC Lab
Methods & Materials Lab
Virtual Construction Lab
PD Koon
Cornerstone
Library
1st Floor Collaboration Suite
2nd Floor Collaboration Suite

Number of People*

Room Setup Requirements

Visit the website for more details on room setup choices.

Audio/Visual Requirements

Food and Beverage Requirements

What is your F&B source?

Live Entertainment? Please describe.

Will you decorate? Please describe.

Billing Information

Payment Method*

Internal Budget Code
Send an Invoice to Primary Contact

Budget Name*

Budget Number*

Notes

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Event Information

Event Details

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