Advisor Approved: _____________________________________ Date: ______________________
Approved: ____________________________________________ Date: ______________________
VPSS or Designee signature
Contact Name(s) (club officer): _________________________________________________________________________
Name of Club(s): _________________________________ Name of Advisor: _________________________________
Program Title: ___________________________________ Program Location: ________________________________
Program Date: __________________ Program Time: ________ to _________
“School Dude” Facilities request Status:
Request Submitted? Yes No Request approved? Yes No
Objective / Goal of Event:
Description of Event:
Intended Audience:
Estimated Attendance: _________
Co-Sponsor: Yes No (If yes, then indicate with whom: _____________________________________________ )
Speaker(s): Yes No (If yes, then indicate the individual/group): _____________________________________ )
Did you Consider? Cash box Liability waivers Security
Catering/food services Locking and unlocking Tables/chairs/trash bins
Decorations Set up and clean up Transportation
Advertising/Outreach (Check all that apply)
Bulletin Board
Door Hangers
Email
Everbridge
Fliers/Posters
News Letter
Phone
Siskiyous.edu
Table Tents
Word of Mouth
Other: ______________________________
Advertising start date: _________________
Budget
Estimated Cost: _______ Source of funds: _______________
Purchase Order:
Yes
No
Club Check Request
:
Yes
No
If yes, please indicate amount:
__________
Description of purchases:
__________________________________________________
Event Proposal for Student Clubs
Must be submitted to the Vice President of Student Services Office no less than 14 calendar days before the event