**Form Used Only for Facilities NOT for Reserve in the
College’s Event Management System
**
INTERNAL EVENT/ FUNCTION REQUEST
![](html/index37121.png)
REQUEST MUST BE TYPED & SUBMITTED
AT LEAST TWO (2) WEEKS IN ADVANCE Today’s Date:
![](html/index37122.png)
Sponsoring Campus/Site Division/Department:
![](html/index37123.png)
INTERNAL EVENT DETAILS
![](html/index37124.png)
Organization/Group: Approx. No. of Participants:
![](html/index37125.png)
Date of Internal Event: Day of Week:
![](html/index37126.png)
Internal Event Time/Duration:
![](html/index37127.png)
Location of Event- Campus/Site: Building/Room:
![](html/index37128.png)
Description of Internal Event:
SPECIFIC REQUIREMENTS
Room Configuration -
Describe Below: (Required - Attach diagram of set-up on separate page.)
![](html/index37129.png)
Media Services –All media equipment/services requests must be requested and confirmed with
Media Services
.
Delgado Police Presence -
Describe below. Police requirements, including non-negotiable officer detail number and cost, to be determined by Delgado Police Chief. See “
Campus Police Presence Requirements for On-Campus Events & Functions
.”
![](html/index371210.png)
Facility Scheduling Coordinator
: Printed Name: ____________________________________________________
Signature (Required): ______________________________________________
![](html/index371211.png)
Requestor’s Name Approved: _______________________/____
|
Requestor’s Department Head/ Date
|
![](html/index371212.png)
Department:
![](html/index371213.png)
Phone: ________________________/____
Department Head over Facility/ Date
![](html/index371214.png)
For Office Use Only: Delgado Police _________________________________________________________________________________ Central Utilities _________________________________________________________________________________ Building Services _________________________________________________________________________________
Copies: Requestor; Facility Scheduling Coordinator; Building Services; Central Utilities; Delgado Police
Form 4310/001 (12/16)
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