Event Reservation Form For use by community, non-profit and for profit organizations, as well as UConn faculty and staff. Group type* University Departments Non-UConn Registered Student Orgs Registered Student Clubs should complete the event registration form on the Stamford Student Activities webpage. Club Requests for space will not be considered unless the Student Activities form is used.Program InformationTitle of Program/Event* Department/Organization* Describe the purpose of this Program/Event Who is sponsoring/hosting the event? Estimated Attendance Affiliation*Business (for profit)Non-profitStaffFacultyOtherStart Date* MM slash DD slash YYYY End Date* MM slash DD slash YYYY Setup Start Time* : Hours Minutes AM PM AM/PM Event may not start earlier than 7:00 a.m. Monday - Saturday. Building is closed on Sundays.Actual Event Start Time* : AM PM AM/PM Event may not start earlier than 7:00 a.m. Monday - Saturday. Building is closed on Sundays.End Time* : Hours Minutes AM PM AM/PM Event must end by 10:30 p.m. Monday - Thursday, 4:30 p.m. on Fridays & Saturdays. Building is closed on Sundays.Rooms requested* Gen Re Auditorium (200 people lower, 90 upper) Multi-Purpose Room (50-100 people) Conference Rooms (30 people) Schreiber Reading Room (49 people) Atrium/Light Spline (150 people) Concourse (300-400 people) Classrooms (24-48 people) Check all boxes that apply to your request. Pictures of rooms can be seen at: http://stamford.uconn.edu/event-facilities/available-rooms-capacity/Information Technology or Audio/Video needed* Podium Podium with microphone LCD projector P/C or laptop connection Desktop microphone Lavalier microphone (for lapel) Wireless handheld microphone Hearing assisted devices Standing microphone N/A - No Technology or Audio/Video required Layout DescriptionPlease provide a brief description of how you would like the room to be set up.Primary Point of Contact Name (may not be present during the event to assist)* First Last Phone for Primary Point of Contact who will be present on the day(s) of the event*Email of Primary Point of Contact on the day(s) of the event* Name of budget/finance person in the organization making the reservation who can be contacted to arrange payment.* First Last Address of budget/finance person Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone for budget/finance person*Email for budget/finance person* Will food and beverages be provided at the event?* No Yes If alcohol is being served?* No Yes N/A -- no alcohol being served If yes, caterer must have state liquor permit and license to serve. Authorization must be pre-approved by UConn Events Manager prior to the event.Will minors be in attendance?* No Yes Anyone under the age of 18 years old participating in the program.CaptchaUntitled First Choice Second Choice Third Choice PhoneThis field is for validation purposes and should be left unchanged.