* deontes required item

* Event Name:  
* Event Date:  
Room Assigned:  
* Arrival Time:  
* Published start time:  
* End Time:  
* Requested By:  
* Contact Phone:  
* Contact email:  
* On-site Contact Name:    Phone: 
Type of Set Up Requested:     Lecture - number of chairs: 
  Card Table / Chair
  8-foot rectangular tables - number of tables:   with seating for: 
  Large Rounds - number of round tables:   with seating for: 
  Medium Rounds - number of round tables:   with seating for: 
  Custom Set Up (Please be specific)
 
Additional needs:     Podium
  Music Stand
  Easel
  Pitchers of Water
  Stage
Other:
 
Audio/Visual:     Microphone - handheld qty.:   lapel qty.:: 
  Large TV with HDMI & VGA
  Projector
  TV / VCR
  TV / DVD
  CD Player
Other: