Facilities Rental Request

External Program Rental Request
Group Name
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Group Contact Person*

First NameLast Name
Contact Email*
Contact Phone #*

Area CodePhone Number
Start Date*

MonthDayYear
End Date*

MonthDayYear
Day (s) of the week

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Start Time*

Hour Minutes

AM/PM Option
End Time*

Hour Minutes

AM/PM Option
Additional days and/or spaces
If looking for specific dates, you may provide them here.
Location requested*

Shipley Center ClassroomShipley Center Dance StudioShipley Center Fencing StudioShipley Center Court 1 (Regulation BB Court)Shipley Center Court 2 (Practice Court)Shipley Center PoolShipley Center Squash CourtsShipley Center TrackBardwell AuditoriumBeveridge HallWaldo Assembly HallOther(Fields etc.)
If Other, please describe location requested.
Number of Attendees*
Parking (check all that apply)*

CarsBusesOther
Campus Safety Needs
(parking, extra officer, room unlocked/locked)
Room Set-Up
Please provide the number of chairs, tables, etc. and requested set-up.
Should be Empty: