Facilities Request Form

Today's Date:*

 

Room/Area Requested:*

  Select... Large Conference Room Small Conference Room (as is) **Pavilion
**If you are requesting the outside area behind the Commons Building please explain further your request in the "Other Set Up Description or Comments" below.

Event Date:*

 

Event Title:*

 

Estimated Attendance:*

 

Event Purpose:*

 

Type of Event:*

  Select... Meeting Performance Luncheon Reception Practice Exhibit Information Table

Event Time:*

    AM PM   to      AM PM

Set-up Time:*

    AM PM   to      AM PM
There is a two hour limit on room reservations. Exceptions must be made in writing to slyle1@missouriwestern.edu.

Food Service:
Will food or beverage be served?*

  No   Yes - If "yes" orders must be placed with ARAMARK Food Service, 816-271-4435, at least 14 business days prior to the event date. Bringing food in from the outside by either the sponsor or event participants is prohibited unless otherwise indicated.

Is there a charge to attend the event?*

  No   Yes - Requests by student groups for fund raising activities must be granted by the Dean of Student Development. Once you submit your request the Dean will review it within 5 working days. Employees may not host fund raisers.

Will music be played?*

  No   Yes - Note: Live amplified bands or DJ's are not allowed except by written permission from the Director of the Office of Residential Life. Dances are not permitted.

Name:*

 

Org./Dept.:*

 

Address:*

 

Phone:*

 

E-mail:*

 

Advisor's Name:

Campus Address:

Phone:

E-mail:

Please select the set up you wish to have based on the choices below. If your choice does not appear below please describe your set up below.* Other Set Up Description or Comments

Other Information

Presentation Equipment - The room is equipped with a video projector and DVD/VHS player. Users needing a laptop should contact Classroom Services at 271-4395. Also available is an overhead projector.  Screens are installed in the large conference room.

Public Safety - Some events may require Public Safety. This determination is the discretion of the Director of Residential Life and the Dean of Student Development. It is the responsibility of the sponsoring organization/ department to contact Public Safety and make the necessary arrangements at least 14 working days prior to the date of the event.

Scheduling Your Event - A fully completed and signed Facility Request Form (FRF) including details of the event is required no less than three (3) business days prior to the use of the facility. Reservations are not considered final until an approved copy of the facility request is returned to the applicant. No events can be held without a signed FRF. Reservations less than 3 business days may be approved based on availability and staffing.

Events must be sponsored by a campus department or official student organization. Representation by the sponsoring group must attend the event. Student events must have their advisor present. Users will pay for any damage to the Commons and/or its equipment.

Liability - It is understood that Missouri Western State University and their members, officers, directors and employees shall not be liable for injury to persons, or for loss or damages to any property belonging to the Sponsor arising in any manner from the event. The sponsor assumes full responsibility and liability for all injury to any and all persons or property in any way connected with the event.