EVENT NUMBER
MC - ON CAMPUS SPACE RESERVATION CONTRACT
This contract is for the use of College Faculty, Staff and Student Organizations. Student Organizations must have
advisor's signature and Dean of Student Development or Student Activities Coordinator/Director. No space may be
used unless a request has been approved by Facilities. Availability of space must be checked in advance with the
Campus Facilities Office. This contract must be submitted five (5*) working days prior to the scheduled event, failure
to do so will result in denial of the request to use the facility. Request for Services Form 8.113b must accompany this
contract if services are requested. *IT/Theater Tech requests need a ten (10) working day advance notice for equipment
set ups. Please note that this event may be cancelled due to an instructional event or weather emergency.
CANCELLATION OF AN EVENT REQUIRES THREE (3) WORKING DAY'S NOTICE.
Name of Applicant Date
Dept./Instr. Unit Phone
Space Requested
HOURS RESERVED
(include set up and clean up time)
DESCRIPTION OF EVENT - Check appropriate boxes: EXPECTED ATTENDANCE
Lectures
Film Social Other
GROUP SPONSOR CERTIFICATION
I agree to be responsible for the College group's activity and
conduct, to be present during event.
ADDITIONAL APPROVAL (if required)
Comments/Notes:
Unit Administrator/Authorized Designee
Date
FACILITIES OFFICE USE ONLY
Comments:
Date Received
Request for Services attached
Yes No
-------------------------------------------------------------------------------------
Campus Facilities Representative
Date APPROVED DENIED
Form 05/20/19 DISTRIBUTION: Facilities • Bldg.Services • O&M • Security • Other Services - Requestor
Will the event include participation of minors, defined as individuals under the age of 18 who are not enrolled at Montgomery College? Yes No
If yes, user is responsible for complying with the Protection of Minors Policy and Procedure (75005CP), including contacting the Youth Protection Coordinator at
least 30 days prior to the event. Events that are not reviewed and approved may be prohibited from operating.
