Facilities Use Request - External Clients - Conference & Events Services

Today's Date:

Event Details

Event Date

Month

Day

Year

Duration of Event:

Single day.

Repeating (e.g., one Monday every month).

Multi-day (e.g., three days long). Please provide additional dates:

Location of Event Flint - Main Campus
Clio - Northern Tier Center
Fenton - Southern Lakes Branch Center
Lapeer Extension Center

Additional Details:

Event Name:

Brief description of Event:

How many attendees?

Facility Access Time:

Hour

Minute

am/pm

Event Start Time:

Hour

Minute

am/pm

Event End Time:

Hour

Minute

am/pm

Facility Exit Time:

Hour

Minute

am/pm

Room Organization

Room Setup:

Tables in U-Shape

Standard classroom configuration

Other(Please Specify)

Please indicate how many of the following items your event will require.

Easels

Podium

Registration Tables

Chairs for registration tables

Other items? (Please Specify)

Organization Details

Name of Organization?

Type of Organization. Non-profit
For-profit

How did you hear of MCC?:

Do you have a Certificate of Liability Insurance? Already provided to the Events Office
Will send to the Events Office

Will print or digital marketing and promotional materials be used to promote this event? Yes - Send all event marketing and promotional materials to [email protected] for approval prior to the scheduled event as outlined in the Non College Sponsored Event Disclaimer.
No

Contact Information

Contact person

Work Telephone

Cell Phone

Address:

Street

City

State

Zip Code

Email Address

Representative Attending

Please enter details for the organizational representative attending the event if different from above.

Representative

Work Telephone

Attending Representative's Cell Phone Number

Address:

Street

City

State

Zip Code

Email Address

Billing Details

Please enter the billing name and address if different from above.

Name:

Work Telephone

Cell Phone

Address:

Street

City

State

Zip Code

Email Address

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