Space Reservation Form: 51�ԹϺ��

Organization or Individual Name:*

Name of Contact Organizing Proposed Event:

Contact Telephone Number:*

Contact Email Address:*

At which 51�ԹϺ�� location would you like to host your event?:*

Macon Campus or Professional Sciences Center (Conference Center)
Cochran Campus
Dublin Campus
Eastman Campus
Warner Robins Campus

Do you have a specific space or room in mind for your request? If so, please list here::

Length of Event (including set-up):*

Multi-Day
Full Day (Up to 8 Hours)
Half Day (2-4 Hours)

Proposed Event Start Date:*

Proposed Event End Date:*

Proposed Event Times (list for each event day):*

Type of Event:*

Meeting
Seminar
Breakfast
Lunch
Dinner
Reception
Camp
Other

If Other:

Estimated Number of Participants:*

Will there be minors at the event?:*

No
Yes

Type of Organization:*

Internal (Campus Organization or Faculty Member)
Government
Non-Profit
Corporate
Private Party

Will you need catering?:*

Yes
No
Depends on Cost

Will you need assistance with event planning or conference support?:*

Yes
No

Please list any general comments, questions or information regarding your request:

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