Conferences and Events Request Form
Name
*
First Name
Last Name
Phone
*
Email
*
example@example.com
SCSU Department/Org Event?
*
Please Select
Yes
No
Department Name
*
Index #
*
Is there a registration?
*
Is the general public invited?
*
Preferred Room
*
Please Select
Alumni Room
Ballroom A
Ballroom B
Grand Ballroom
Lyman
Seminar Room
Theater
Organization Name
*
Organization Type
*
Event Name
*
Event Description
*
Estimated Number of Attendees
*
Event Duration
*
Please Select
Single Day
Multi-Day
Preferred Dates
*
Please submit in mm/dd/yy format and comma between dates, i.e. mm/dd/yy, mm/dd/yy
Preferred Time
*
Audio / Visual Service Request
*
*if yes, please describe
Do you require Food and Beverage?
*
Please Select
Yes
No
*Any food provided must be arranged with University Food Services
Do you require housing accommodations?
*
Please Select
Yes
No
Please provide some general information regarding your request and/or a brief description of your program:
How did you hear about us?
Submit
Should be Empty: