Mathy Center Lease Request Form

This intent of this form is for facility usage requests with the exception of conference room reservations.
To reserve a conference room, contact
Basic Information:
  Sponsoring Department / Organization: 
 Contact:     Email: 
  Phone:      Address:    
Event Information:    
  Activity/Event Name:   Type of Function:       
   Estimated Attendance:     Is this a one time or reocurring event? 
  Start Date:   Stop Date:
  Start Time:     End Time:
  Setup Time:   Tear Down/Cleanup Time:
Room Requests: (Indicate all that apply)  

Additional Event Information
(Use this space for recurring event dates and alternate date or location options for the event)
Event Requirements:
Tables (Quantity):                         Chairs (Quantity):

Other Needs:
University Departments / Groups Large Event Setup amd Teardown:
If there are any questions, feel free to contact the Amie L. Mathy Center
Phone: 608-796-3120