Internal Facility Usage Request Form
(Request by Faculty/Staff for any College Event/Activity)
Employee: Department:
Job Title: Employee ID #:
- Name of Event:
- Purpose of Event:
- Date(s):
- Time(s):
- Campus:
- Facility(s):
- Room #(s):
- Est. Participants: ______ # of Students ______ # of Guests _____ # of Administrators/Faculty/Staff
SERVICES REQUESTED
1. _____ Wi-Fi _____ A/V _____ Screen/Projector _____ Podium Other: _____________________________
2. EQUIPMENT: Tables & Chairs Set-Up, Tent, etc. (specify number of chairs and tables needed and for which locations if more than one area will
be utilized)
:
3. FOOD SERVICES are subject to prior administrator approval and are the responsibility of the requesting department.
Approval is based on the requesting department’s available funds and purpose.
a. Funds Available: $_______________ Account #: ___________________ Administrator Approval: _____________
b. Purpose (ex. working lunch, refreshments for special guests, etc.): _________________________________________
4. CUSTODIAL: _____ # of Custodians needed to work the event □ Begin Time ___________ End Time __________
5. OTHER: (Please Specify)
Employee Signature: Date:
Administrator/Supervisor Signature: Date:
****Once approved by your supervisor/administrator, send this form to the appropriate individual
listed below that corresponds with the campus of the event****
GT: Sheila Skelton
MV: Kay Lett
AT: David Lanier
BF: Mark Sloan
BM: Teresa Sutherland
BR: Sharon Morris/Richard Lynn
FH: Mandy Bezeredi
GS: Ed Douglas
TV: Kiki Moore
To have your event added to the College's online calendar or to request media coverage, go to
www.CoastalAlabama.edu/pr
to complete your request.
Approved by: Date:
Campus Director or Designee
click to sign
signature
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click to sign
signature
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