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Activity Request

Please complete the form below. Required fields marked with an asterisk *

Primary Contact Person's Email*

Answer Required

Name*

Answer Required

Sponsoring Organization*

Club, Team, Program

Answer Required

Activity / Event Name*

Answer Required

Activity Description

Answer Required

Activity Date*

Answer Required

Additional Dates (if applicable)

Answer Required

Setup Time*

Answer Required

Event Time (Inclusive) *

i.e 9:00 AM-12:00 PM

Answer Required

Take down/Clean up Time*

Answer Required

Periods Affected*

Answer Required

Location Requested*

Check the Calendar for Availability

Answer Required

Number of Students Participating*

Answer Required

Names of Adult Supervisors*

Answer Required

Name of Supervising Administrator*

Please check with Administrator for availability before putting their name down.

Answer Required

Equipment Requested*

Answer Required

Microphone/Sound System

Projector

Tables/Chairs

Podium

Other:

Confirmation Email

Email Required