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