YUBA COLLEGE ON CAMPUS CLUB/ORGANIZATION
ATTN: CAMPUS LIFE Date of Application
Phone: 530-741-6992
Fax: 530-749-3884
APPLICATION FOR
ACTIVITIES, FACILITIES AND/OR SERVICES
REQUESTED BY
CONTACT PERSON: TELEPHONE
ACTIVITY
DATE OF EVENT TIME TIME IN
TIME OUT
ROOM(S)/FACILITIES
EQUIPMENT/SERVICES
Please provide a diagram if special set up is needed.
# TABLES
LECTERN
BOX OFFICE RESTROOMS
MEDIA SERVICES
MEDIA TECHNICIAN
THEATER TECHNICIAN
OTHER
*YUBA COLLEGE DOES NOT PROVIDE CHAIRS FOR ANY EVENT.
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• Arrangements must be made at least 14 working days in advance of the event.
• Cancellation notice must be submitted 48 hours prior to the event or 72 hours if food
Services are requested.
• Food service MUST BE requested first through Food Services 741-6933, if not available then
through Chartwells 741-6806.
• Applicant will be notified in writing of the acceptance/rejection of application.
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• ATHLETIC DEPARTMENT Must have prior approval of the Athletics Director, ext. 6838 or 6779.
Signature Date
• DINING FACILITIES Must have prior approval from Cafeteria Management, ext. 6806.
Signature Date
• THEATRE FACILITIES Must have prior approval from Theatre Department, ext. 6829 or 6984.
Signature Date
• FACULTY ADVISOR/BUDGET MANAGER Final Approval
Signature Date
