Facility Request Form

Completed by:

Extension:

Person responsible:

Department:

Event:

Facility requested:

Event date:

Year:

Start event time:

a.m. p.m.

End event time:

a.m. p.m.

Setup and clean up time required:

Approx. number of people expected:

This section pertains to The Barn only.
For use of the Alumni Room in The Barn, indicate desired room set-up: (view set-up options at: http://nzr.mvnu.edu/facilities/barnsetup.pdf). Include number of chairs and tables needed in the Alumni Room if applicable.

Seating arrangement: (See link above)

Number of Tables:

Number of Chairs:

Note: A two-week notice is required when requesting tables and chairs.
Food service needed: Contact Austin Swallow at extension 4471.
Note: Vehicles must park in designated parking areas. Vehicles are not permitted to park next to The Barn or on the grass.

Special services requested
Enter a "Y" or "N" following the possible services needed below

Housekeeping/Physical Plant		Y N
Housekeeper On Site		Y N
Please list any special setup needs -- tables, chairs, etc.

Safety & Security		Y N
Computer projection needed:		Y N
VHS/DVD projection needed:		Y N
(Computer/video/projection needs must be coordinated with the Technical Response Center, x5555.)

Sound details of the event
Sound & Lighting (ext. 5549)		Y N
Sound assistant needed throughout entire event?		Y N
Sound assistant needed only at beginning of event?		Y N
Sound check time:		AM PM
Speaking microphone:		Y N
Wireless lapel microphone:		Y N
Vocal microphone:
Choir microphones:		Y N
Instrument microphones (guitar amps, piano, etc.):		Y N
Direct boxes for instruments:
Drum set or percussion needing microphones:		Y N
Sound for Video, DVD, or computer: (you must also coordinate with the Technical Response Center ext. 5555 to get video projection, TV screen, powerpoint, etc.)
Y N
Audio Record this event?		Y N
If Yes, Account number to be charged?
Video Record this event?		Y N
If Yes, Account number to be charged?

Food Service

Pioneer Catering?

Y N