ALL IN ONE REQUEST FOR CAMPUS ACTIVITY:
This form must be turned in 10 business days prior to the date of event.
CLUB CLASS DEPARTMENT
NAME (Department; Class; Club):
CONTACT NAME & PHONE #:
DATE & START/END TIME OF EVENT: ___________________________________________
CAMPUS & LOCATION:
EQUIPMENT NEEDED: TENTS #_______ TABLES #_______ CHAIRS #_______
COOLERS #_______ ICE SPEAKERBOX MIC
GAMES _________________________________________________
PURPOSE OF REQUEST: (Please give detailed description)
OPEN TO THE PUBLIC CLUB MEMBERS ONLY
FLYER ATTACHED (10 business days prior to the date of event)
IBOX REQUEST ATTACHED (10 business days prior to the date of event)
2 Account Funds Requested
6 Account Funds Requested 6-____________________________
Items Requested for Purchase: (attach additional forms if needed)
PIZZA #______
TOPPINGS __________________________
SODA #______ WATER #______
TYPE________________________________
PLATES/NAPKINS
FLATWARE
1.____________________________
2.____________________________
3.____________________________
4.____________________________
5.____________________________
SIGNATURE:
Daytona State Employee Only
*RETURN THIS FORM TO THE STUDENT LIFE DEPARTMENT*
BUILDING 115 Room 219 or Email to studentlife@daytonastate.edu
