Name of Student Organization/ University Department:

Name of Requestor:

Contact Phone Number:

Contact Email:

Choose Dining Hall(s), Meals and Dates Requested: (LUNCH 11:00 - 2:30; DINNER 4-9)


First Option

Date

Dining Hall

Time


Second Option

Date

Dining Hall

Time


Third Option

Date

Dining Hall

Time


Do you request the use of a Table & Chairs?

Do you need the use of an Electrical Outlet?

Purpose, in full detail, to be filled out by Requestor:

I will Conduct the soliciting in an orderly manner and will keep the display area free of all unsightly material.