Clearing House Form for College Activities Revised 8/12/2015
PASADENA AREA COMMUNITY COLLEGE DISTRICT
CLEARING HOUSE FORM FOR USE OF COLLEGE PROPERTY
Office of Business Services-Campus Use Pasadena City College, Room C121
PHONE: 626.585.7233 FAX: 626.585.3141
Event Day Event Date
Month Day Year
Set-Up Start Time: Event Begins at: Event Ends at: Room Use End Time: _
*Please include time for vendor drop-offs, catering set-up, etc. in the set-up time so facility is booked for the entire time needed.
Event Name: Estimated Attendance:
*In case of cancellation, 48 hour written notice must be given to the Office of Campus Use at campususe@pasadena.edu
LOCATION OF EVENT (Check the appropriate box)
Amphitheatre
C333
Campus Center Circle (1/2 circle in Quad)
*Circadian
*Circadian Patio (only w/Circadian)
*Creveling Lounge
Forum Patio
G1
G2
Harbeson Hall
Library Terrace
Plaza
Quad- Section (1-7)? _
R122
Sexson Auditorium
Wifi Lounge
Classrooms/Labs: _
Other: _
Round Tables Rectangular Tables Chairs Per Table Total Chairs
Floor Plan Attached? Yes No *Floor plan is required for use of Circadian, Creveling, and all outdoor spaces.
Food to be served? Yes No Outside vendors/sponsors? Yes No
Amplified sound? Yes No Do you need a tech? Yes No
Special Requests?
Does this event involve non PCC attendees? Please explain:
Reserver: Ext: _
Department: _
*Day of Event Contact: Cell Phone Number: _
FILL OUT A STAGING SERVICES FORM for events using technical equipment; i.e., microphone, public address system, presentations, and for rooms
with specialized equipment. Call Ext. 7045 if you have any questions. Submit your staging services form and clearing house form to Campus Use.
CALL MEDIA SERVICES at Ext. 7292 for all media equipment; i.e., TV/VCR, photo documentation, videotaping services, overhead projector, slide
projector, training, etc.
CALL FOR FOOD SERVICES at Ext. 7793 for catering services. *Food is only allowed inside Circadian and Creveling Lounge.
This completed form must be returned to the Office of Campus Use, C121, at least two weeks prior to event. Due to the scale of some events, at
least 6 months may be required in order to approve all components of event. If your event is going to be facilitated by an outside company it may
qualify as a civic event and require a different reservation process. Please contact Campus Use for questions/clarification on the differences.
Manager/Dean/Faculty Signature: Print Name:
Office of Campus Use Date: Initials:
Office of Campus Use Campus Police Facilities Staging Requestors Copy
click to sign
signature
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