Name of Activity:
Division / Department:
Submission Date:
Sponsor of Event:
Email Address:
Contact Person:
Phone Number:
Activity Date:
Activity Time:
Campus Location:
Room / Building
Detailed Event Description:
Reservations for security, maintenance, tables, chairs, a/v equipment, etc. are the responsibility of the contact
person.
Activity has been approved by the Bishop State Police Chief.
YES
NO
Signature / Date
Activity has been approved by the Executive Director of Facilities.
YES
NO
Signature / Date
Activity has been approved by applicable Dean.
YES
NO
Signature / Date
Activity has been approved by the President.
YES
NO
Signature / Date
Please submit a completed form with handwritten signatures to
the President’s Office at least two (2) weeks prior to event.
For Office Use Only
College Activity Request Form
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