Application For Use Of Facilities Form - Middle Tennessee State University
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1
2Application for Use of Facilities
Application Is Contingent Upon Approval
Title of Event _________________________________________________________________________________________
Event Type (check one)
Student Sponsored
Academic Course Related
External
University Sponsored
Co-Sponsored
Index No. ______________________________
MTSU Affiliated Organization ____________________________________________________________________________
Non-Affiliated/External Organizations (if applicable) _________________________________________________________
Total Event Expected Head Count ___________________
Age Group of Participants __________________________
Individual to be present and responsible ___________________________________________________________________
MTSU ID M# (if applicable) ____________________________
Cell No. ( ________ ) ________ - _______________
Date(s) Requested _____________________________________________________________________________________
Event Set-up Time _________
Start Time _________
End Time _________
Breakdown Time _______________
Location Requested _______________________ Room ____________
Room Expected Head Count ______________
Date(s) Requested _____________________________________________________________________________________
Event Set-up Time _________
Start Time _________
End Time _________
Breakdown Time _______________
Location Requested _______________________ Room ____________
Room Expected Head Count ______________
Date(s) Requested _____________________________________________________________________________________
Event Set-up Time _________
Start Time _________
End Time _________
Breakdown Time _______________
Location Requested _______________________ Room ____________
Room Expected Head Count ______________
Set-up and
Special Needs
Event Resources Requested
Chairs
Audio
Outdoor Sound
Food
(check all applicable)
Tables
DVD/Film/Video
PowerPoint
Special Parking
Open to General Public
Yes
No
Products for Purchase
Yes
No
Tickets Required
Yes
No
Distributing Advertising Materials
Yes
No
Admission/Registration Fee
Yes
No
Minor Participating
Yes
No
Some services are venue specific. Additional forms may be required. Additional charges may apply.
Event Description
Event Category (check one)
Agriculture
Alumni
Arts
Athletics
Conference/Camp/Lecture
Testing
Do Not Publicize
Faculty/Staff Meeting
Recreation/Wellness
Student Activity/Event
Other ____________________________________________________________________________________________
Event Website _________________________________________________________________________________________
Page 1–Signatures required on page 2, both pages required
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Parent category: Business