Facilities Rental Request Form

*Email Address

*Contact Name

*Name of Organization

*Phone Number

*Event Start Date (mm/dd/yyyy)

*Event End Date (mm/dd/yyyy)

*Start Time (requested/preferred)

*End Time (requested/preferred)

*Day of the Week (preferred)

*Number of Participants

*Desired Location

Gym Space Field Space Classroom Space Performance Space Residence Hall(s) Other (please list below)

*Additional Information