LDS Center Reservation Request Form

I. Requester Information

First & Last Name*:
Status*:
Department*:
Phone Number*:
Email Address*:

II. Event Information

Event Title*:
Group/Organization*:
Event Type*:
If other, please describe:
Space*:
Requested Date and Time (MM/DD/YYYY):
First Choice*: select Time:
Second Choice*: select Time:
Anticipated Attendance*:
Open to Public*: Yes No
Serving Food*: Yes No
Resources: Banquet Tables (Amount: / 40)
6-ft. Rectangular Table (Amount: / 6)
Chairs (Amount: / 600)
Laptop/Internet
Microphone/Podium (Amount: / 2)
Projector/Screen
Other Resources:

III. Event Description*

Briefly describe what the event is, and how it is appropriate for the Center for Leadership & Service:

Please submit this form no later than two weeks prior to your requested reservation date. You will be contacted within two business days to discuss the details of your event and confirm reservation. Please inform the building manager of any changes in your request or cancellations as soon as possible in order to allow us to offer your space and time to others.

Please note: All requests are subject to approval by the LDS Center director; completion of this form does not guarantee a reservation. You may call or email Carl Wiltshire at any time to request a status update on your request.

Carl Wiltshire
Phone:631-632-4914
Email: carl.wiltshire@stonybrook.edu

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