TUCI :: The Urban Child Institute :: Room Use Application

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ROOM USE APPLICATION

Please read guidelines before submitting application

Organization Name Address Address 2 Zip Code, City 501(c)(3) Yes No Contact Person Mobile Phone Number Fax Number Email Address Room(s) Requested Meeting Date Reservation Times

allow for set-up and clean-up

Meeting Times

time will be posted in the lobby for guest information

Estimated number of attendees Name of person responsible on site Title of Meeting

to be posted in the lobby for guest information

Calendar

Would you like the event to be posted on TUCI's website calendar?

Yes No Purpose of Meeting How will the meeting impact children Conference Room Auditorium Additional Needs Registration table outside room Markers for whiteboard Projector and Screen Laptop computer DVD/CD player (Auditorium only) VHS Player (Auditorium only) Food and Beverage Verification

I, (ENTER NAME), understand, accept, and agree to the terms of this agreement outlined in the "Guidelines for Meeting Room Use." Failure to adhere to the terms may result in loss of future building use.

Validation Code *

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