CNM Facility Usage Authorization Form

CNM Facility Usage Authorization Form
INSTRUCTIONS: This form is to be submitted to Security ten business days prior to the planned activity/event. The form should be approved by the Department Dean or designee. A copy of the Security reviewed/approved request will be returned to the requester.

The Facility Usage Authorization Form is one tool the Security Department along with others use to ensure CNM employees, students and visitors are SAFE. The FUAN provides necessary information to know when more resources are needed and to facilitate an appropriate response during a campus emergency.
Type of Activity*
Requester (On Site Contact)*
Requester Email*
Requester Phone Number*

Area CodePhone NumberExtension
Date of the Activity*
Date of the Activity*
Day(s) of the Week*

SundayMondayTuesdayWednesdayThursdayFridaySaturday
ONLY for Events: Please provide Set-up Time (other requests enter 1am and 2am) *

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Actual Time of Event/Activity*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
ONLY for Events: Please provide Tear Down Time (other requests enter 1am and 2am)*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Room(s) and/or Other Facilities to be Used*
Location
CNM:

ATCMainMontoyaRio RanchoSouth ValleyWestsideWTC
CNMI:

1008 CoalFuse MakerspaceABQid/STEMulus - Galeria Plaza
Off Campus (Location Site and Physical Address):
Services Requested

For Security requests, please contact Security 15 minutes prior to the start of your event at (505) 224-3002.
Services - PLEASE REMEMBER TO SUBMIT SEPARATE DEPARTMENT WORK TICKETS (10 business days prior of the event) FOR EVENT SUPPORT

ADA services (ASL Interpreter, Closed Captioning, Descriptive, Faculties Access). Arrangements to be made at http://livecnm.sharepoint.com/teams/ADACompliance)Alarm (Security)ASTRA (room reservation)Audio-Visual (Service Now ticket must be submitted via help.cnm.edu)Information Technology, equipment and guest accounts (Service Now ticket must be submitted via help.cnm.edu)Door Opening (Security)Special Event Parking (arrangements to be made at https://www.cnm.edu/depts/parking-and-fleet-services/visitor-parking/special-event-parking)Reserved Parking (arrangements to be made at https://www.cnm.edu/depts/parking-and-fleet-services/visitor-parking/special-event-parking)PPD Event Support, Heating/air, cleanup, furniture request, room set-up ( Service Now ticket must be submitted for services at https://cnmprod.service-now.com/esc?id=sc_cat_item&sys_id=1534dadbff599210f74ff8537c4fd997)MCO services (Marketing, Communication) (MCO ticket must be submitted for services at https://livecnm.sharepoint.com/teams/MCO/requests/SitePages/RequestHome.aspx)Safety/Risk Management (Children under the age of 13, Open flame-Hot Permit, Public figures attending (Celebrities, Government Officials), space heaters, any other safety concerns, etc.). Please complete the Safety/Risk Management Event Checklist at https://www.cnm.edu/depts/finance-operations/risk-management-office
Other Services Required:
Activity/Event Information
Describe activity/event *
Will food be served? (Please indicate food services for the event, such as potluck, food trucks, etc.)*
Will you be needing CNM Shipping and Receiving to Transport Furniture (i.e. Tables, Chairs, Podium, Canopies) for the event?*

Yes, and I will submit a ServiceNow ticket to PPD with detailsNo
Will you be having an "open-flame" (i.e. Grill, Sterno, etc.) at your event?*

Yes, Please contact Safety to obtain a Hot PermitNo
CNM Furniture (please provide an estimate, and remember to submit a ServiceNow Ticket to PPD with details). Thanks
prevnext( X )
CNM Chair
$ Free Quantity



CNM Table
$ Free Quantity



CNM Podium
$ Free Quantity



CNM Canopy (10x10 pop-ups)
$ Free Quantity



Total

$0.00
Will extension cords be used?*

Yes. The Event Organizer will complete a Risk Management Event Form.No
Will extension cords or portable generators be used? *
Will portable generators be used?*

Yes. The Event Organizer will complete a Risk Management Event Form.No
Number of Attendees (Please include staff and volunteers.)If attendance is over 400 or will have the potential of exceeding occupancy, please complete a Risk Management form*
Attach Any Additional Information

Cancelof
Department Head or Designee*
Department Head or Designee Email:*
Please verify that you are human*
Should be Empty:

CNM Facility Usage Authorization Form

Location

Services Requested

Activity/Event Information