!"#$%&'(#'%)(*!"#$%") # +, " ) (- . # ' / +$ 0- 1 +2 +0+, "-
A
PPLICATION
)&)C
ONTRACT
)F
ORM
)
!
Room!use!of!the!M
ULTI
C
ULTURAL
!C
ENTER
!
3&#+2+#4-3%$)-5677-89:
-&);-<=- - 7,">$%$"&$-3%$)-5677-88:-&);-?@ -
.'AB+#-)-B+"+B'B-,>-ONE$WEEK-+"-)/2)"&$-,>-#C$-$2$"#D-
!
First!Name:!________________!Last!Name___________________!Group ! _____________ !
!
Phone#:!(!!!!!!!!)!!!!!!!!!!!!‐!!!!!!!!!!!!!!!E‐mail:!_______________________________________!
!
Request
! Day:!!M!T!W!R!F!!! D a t e:! _____________! ! ! _________,! __________________!
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! ! ! !!!!!!M
onth!!!!!!!!!!!!Day!! ! ! ! ! ! ! ! ! ! Y ea r!
!
Start!time:!____:!______am/pm!!!! End!time:!____:!______am/pm!!
!
Name!of!Advisor/Faculty/S t a ff! ______________________________________________!
(in!attendance)!
!
Phone#:!(!!!!!!!!)!!!!!!!! ! ! ! !‐!!!!!!!!!!!!!!!E‐mail:!________________________________________!
!
Meeting!!!!!!!!Lecture! Social!Event! Club! Conference! Other!_____________________!
!
YES! NO! Have!Event!Included!on!a!public!calendar!online!(view!only)?!
http://www. deanza.edu/iis!
____________________________________________________________________________________________________________________!
Area)Use)Agreement)
By!checking!each!item,!we!comply!with!these!use!requirements:!
1.!!A!Faculty/Staff!will!supervise!the!event!from!beginning!to!end.!
!
2.!!Posted!signs!directing!guest!will!use!blue!tape!and!be!removed.!
!
3.!!Noise!level!will!be!appropriate/monitored!for!a!shared!space.!
!
4.!!Tables!will!be!wiped!and!trash!removed!to!outside!receptacles.!
!
5.!!Tables/chairs!will!be!returned!to!the!original!arrangement.!
!
6.!!Documents/presentations!on!the!computer!will!be!trashed.!
!
7.!!All!doors!to!the!building!will!be!locked!and!checked!upon!exit.!
!
E($)0$-Submit- #C+0->,%B-#,-#C$-!!.-1+2+0+,"-300+0#)"#-F,-3""-GH)A$IJ'A,-)#K-,H)A$H'A,L,)""M>C/)D$/'-