SpeakUpSis Empowerment Center

Venue Request Form

Thank you for considering SpeakUpSis® Empowerment Center to have your next meeting, training, activity, experience. Once your request has been received and reviewed, someone will call you to discuss details of your activity and schedule a tour of the facility.
Contact Person Name*

First NameLast Name
Contact Person Phone*
Please enter a valid phone number.
Contact Person Email*
example@example.com
Company Name
Company Website
Company Phone
Please enter a valid phone number.
Company Email
example@example.com
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Activity Details
Activity Name*
Date of Event*

MonthDayYear
Date
Starting Time (including time for set up)*

Hour Minutes

AM/PM Option
Ending Time (including time for clean up)*

Hour Minutes

AM/PM Option
Activity Description*
Activity Coordinator Name*

First NameLast Name
Number of expected guests*
Please check the room you want to reserve. [There is a 50% deposit required at time of booking. Deposit will go towards final payment.]*

TK3 Meeting Room (max 20 ppl) $85/hrSpeakUpSis Bookshelf (max 10 ppl) $65/hrConnection Hub (max 30 ppl) $85/hrSUS Empowerment Center (max 50 ppl) $125/hr (2hr minimum)
Any additional information:
Restrictions
No Smoking
No Pets allowed [Service animals are welcome but must be noted at time of booking.]
Illegal drugs and substances are strictly not allowed on premises
Should be Empty:

Venue Request Form