Student Organization Facility Request Form Revised 1/2013
AAMU Student Health & Wellness Center
HOURS: M-F: 6 a.m. – 10 p.m.; Saturday: 9 a.m. – 6 p.m.; Sunday: 1 p.m. – 7 p.m.
Space is not reserved until you have received a confirmation from the Student Health and Wellness Center. To insure a quality
rental experience and adequate processing time, please submit your facility request form at least 14 DAYS in advance. Group must
be a University recognized student organization.
Name: ________________________________________________ Today’s Date: _____________________
Group: ________________________________________________ Phone #: _________________________
E-mail: _____________________________________________ ___ Fax #: ___________________________
Type of Event: ___________________________________________ Estimated Attendance: ______________
Purpose of Activity:____________________________________________________________________________
*Bowling Alley # of lanes 1 2 3 4 5 6
*Separate fee
Equipment Needed:
_____ Basketball(s) (#_____) _____ Volleyball(s) (#_____) _____ Other____________________________
*Upon approval, chairs, tables, etc. should be secured by placing a work order with the Department of Property Management and faxed to
their office (256) 372-5545.
*Upon approval, audio visual equipment should be requested, in writing, from the Telecommunication Center or reserved through the LRC
Media Center.
1. Please check whom the program is open to: [ ] AAMU Students [ ] AAMU Faculty/Staff [ ] Alumni/Community/External
2. Will an entry fee be charged to participate? ________ YES (if yes, how much?___________) _________ NO
My signature below indicates that the person, department or unit requesting space is financially responsible for all related
charges for services or damages to facility. I have read, understand and agree to the SHWC Facility Usage Guidelines.
_______________________________________________ ________________________________
Applicant’s Signature Date
_______________________________________________ ________________________________
Advisor’s Signature Date
Send the completed and signed facility request form to the address listed below. An e-mail will be sent to you
alerting you to the status of your request. Thank you.
Return to: Student Health & Wellness Center FOR OFFICE USE ONLY
Alabama A& M University Date Received: ____________________
P.O. Box 1567 Received By: ______________________
Normal, AL 35762 Approved/Denied By: _______________
(256) 372-7000 - Office Dated entered into calendar___________
(256) 372-7005 – Fax Response Method: __________________
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