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?
*
Please Select
Yes
No
Is the general public invited?
*
Please Select
Yes
No
Preferred Building(s)
*
Preferred Room(s)?
*
eg. ENA105, ENS107, ENA109
Organization Name
*
Is your Organization a Non-Profit?
*
Please Select
Yes
No
Organization Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization Phone Number
Please enter a valid phone number.
Organizations Preferred Venue
*
Please see our list of
Venues
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: