Campus Activity Proposal Form
This form shall be used for all approved student organizations,
PLEASE READ BEFORE COMPLETING THIS FORM:
1. Please check the date availability of your desired activity by visiting our Berkeley
City College website event calendar; a request does not guarantee a reserved space.
2. Your request must be submitted 4 weeks prior to the date you desire or the activity
cannot take place.
3. Please make sure you have obtained all approvals/signatures prior to submitting
this request. Your request will not be considered unless you have all the required
4. Please attach a short summary of the activity or event you are requesting.
5. Please do not assume your request is approved until you have received
confirmation that it has been approved. Therefore, please do not advertise, book
speakers, or make arrangements until then.
RETURN THESE FORMS TO: Office of Student Activities & Campus Life Room 151
(510) 981-5012 email: email@example.com
TYPE OF ACTIVITY REQUESTED:
□ Other: _________________
Name of activity: _________________________
Brief description of activity: (attach additional
sheet if needed)
□ Atrium □ Auditorium □ Student Lounge 5
floor □ Classroom □Welcome Center
□ Other: _________________ Will you require audio visual, IT support, or custodial
assistance? □ YES* □ NO
*If yes, please fill out attached request forms
Day of week: ____________________ Date: _____________________
Prep time before: ________ am/pm. (Includes decorating, displays, hangings, etc.)
Beginning time: _________ am/pm. End time: _________ am/pm. You have up to 1
hour to remove all decorations; it is your responsibility and we are not responsible for
any lost, stolen, or damaged items before, during, or after your activity/event.
□ Student Organization* □ Faculty □ Staff
*For student Organizations, please fill out the “student organization” section on the next
Name of requestor: ____________________________ Student ID#:________________
(PRINT LEGIBLY) (STUDENTS ONLY)
Requestor signature: _____________________________ Date: ___________________
Email (required):_________________________ Phone number: ( ) _____________
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