Reservation Request Form printable pdf download

HARRIS HALL ROOM 108 RESERVATION REQUEST FORM

1881 SHERIDAN ROAD

Please read the Rules and Guidelines on the next page before filling out this form completely.

Once the form is complete, please return it to Eric West in one of the following ways:



Scan and e-mail the document at

e-west@northwestern.edu



Fax the form to the History Department at 847-467-1393



Mail or deliver the form in person to WCAS History, 104 Harris Hall, Evanston Campus 2220

Reservation Information:

Name and Title of Contact Person:

Department/Organization:

Complete Address or Campus Building/Room:

Telephone Number:

Name and Title of Key Person

(Please list one person only)

Reservation Day and Date:

Time Requested: _Start Time:

Ending Time:

Event Title:

Number Expected to Attend:

(Seating Capacity is 60; Total Room Capacity is 80 people, per Evanston Fire Inspector)

Will food and beverages be served at your event?

Yes____ No____

Will you request Facilities Management (through FAMIS) to move furniture for your event?

Yes____ No____

[If “Yes,” please submit a copy of your FAMIS request and a diagram of the furniture layout so that we can verify with FM.]

Will you be using the A/V podium at your event?

Yes____ No____

If you want to ensure on-site coverage of the A/V system in case of unexpected technical difficulties, please submit a request with

Weinberg IT noting the date and time of your event at otherwise, call 7-ROOM during your event.

What chart string will you use for this event?

(All departments must submit a chart string for security/damage purposes, though the reservation fee is waived for Weinberg)

Reservation Fee Information: This fee is waived for Weinberg departments and programs.

For all others, please check one:

One Weekday (Mon-Fri, Day or Evening)

___ $200.00

One Weekend Day (Sat-Sun, Day or Evening)

___ $300.00

Consecutive Weekend Days (Fri/Sat or Sat/Sun)

___ $600.00

I have read and understand the Rules and Guidelines for Harris 108. Our organization will accept responsibility for

any damage to the room during the course of our event.

(Signature of Contact Person is Required)

Things to Remember while Filling out the Form:



The Contact Person is the staff or faculty member that we should call if we have a question about scheduling, deliveries, or other

logistics for your event. The campus address and phone number you provide should apply to this person.



The Key Person is the person you have designated to pick up the key for your event and ensure the safety of the room by locking

it when the event is over. The Key Person must be a faculty or permanent staff member who will attend the event in its entirety and

is willing to accept full responsibility for the security of the room.



When determining the start and ending times for your reservation, please allow for the extra time you will need before and after

your event for setup and cleanup, including any deliveries, pickups, or furniture arrangement (if you are not using Facilities Mgmt.).



A chart string is required for all groups, even if the reservation fee is waived. Any repair costs that arise from significant damage to

the room or furniture during your event may be charged to the chart string you provide.

For Dept. Use Only:

Date Reservation Form Rec’d:

Date Confirmation Sent:

Revised 08/18/2015 (ecw)

Reservation Request Form

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