INTERNAL EVENT/ FUNCTION REQUEST
REQUEST MUST BE TYPED & SUBMITTED
AT LEAST TWO (2) WEEKS IN ADVANCE Today’s Date:
Sponsoring Campus/Site Division/Department:
INTERNAL EVENT DETAILS
Organization/Group: Approx. No. of Participants:
Date of Internal Event: Day of Week:
Internal Event Time/Duration:
Location of Event- Campus/Site: Building/Room:
Description of Internal Event:
SPECIFIC REQUIREMENTS
Room Configuration -
Describe Below: (Required - Attach diagram of set-up on separate page.)
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
.”
Facility Scheduling Coordinator
: Printed Name: ____________________________________________________
Signature (Required): ______________________________________________
Requestor’s Name Approved: _______________________/____
|
Requestor’s Department Head/ Date
|
Department:
Phone: ________________________/____
Department Head over Facility/ Date
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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