Ced Faculty, Staff, And Student Room Reservation/event Planning Form
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1CED Faculty, Staff, and Student
Room Reservation/Event Planning Form
Wurster Hall Venue Requested: ________________________________________________________
Event Coordinator: ______________________________________________________________________
Email: ______________________________________________ Phone: ___________________________
Department: ☐Dean’s Office
☐Student Group: ________________________
Sponsor (for student groups/functions):_________________________________________
☐ARCH
☐DCRP
☐LAEP
Event Title: __________________________________________________________________________
Type of Event:
☐Oral Exam
☐Other: _________________
Event Date and Time:________________________________
Estimated Attendance: ________________________________
☐Meeting
☐Lecture
☐Reception
☐Conference/Symposia
Hours of Reservation (include time for set up & clean up): _________________________________________________________
*Note: If the event is outside of regular building hours, a $50-$100 fee may be charged to pay campus facility services.
Description of Event: ___________________________________________________________________________________________________
__________________________________________________________________________________________________________________
Will food be served?
☐ Yes
☐ No
What types of food and beverages (e.g. finger food, boxed lunches, sodas, coffee/tea):
____________________________________________________________________________________________________________________________
Will alcohol be served?
☐ Yes
☐ No
(If yes, you must provide a copy of approved UCPD Campus Alcohol Use Permit.
NOTE: UCPD requires submission of permit application no later than 7 days prior to event.)
Please check for:
Audio/Visual
☐LCD Projector
☐TV Monitor
☐Other: ________________________________________
Note: Video recording can be
☐Mic/Sound
arranged with ETS
Custodial
☐Compost bin
☐Recycle bin
☐Landfill bin
Furniture
☐Tables (how many? _____)
☐Chairs (how many? _____)
☐ Other: ________________________________________
:
CED Facilities Use Policy
Set up and clean up (i.e. stacking of chairs, wiping down tables, disposing of compost/trash, removal of
•
staples and push pins) is the responsibility of the event coordinator.
•
Close and lock doors and windows after use.
•
Sponsoring deparment may be held finanically responsible for any damages resulting from negligence.
•
Do not set up tables in corridor. Maintain 4’ clearance for emergency evacuation.
Items left after reservation hours are liable to be discarded.
•
Any alteration of the space (e.g. painting, removal of equipment) is prohibited. Pin-ups permitted only on
•
plywood and homasote surfaces using push pins or staples.
“I agree to adhere to the CED Room Use Policy.”
Signature: _______________________________________________
Date: __________________
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