Test Space Cases Form A. If you are sponsoring an outside vendor to use MPH space, please email Kristin Bernazzani to request a Facilities Use and Rental Agreement Form. Do not complete this form. B. All events occurring on campus outside of one’s own classroom or office must utilize this form. C. The Space Cases Calendar must be consulted for available space before completing this form. D. Approved events will be confirmed in an email to the event coordinator/advisor. E. Approved events will be added to the Space Cases Calendar. Event Coordinator/ AdvisorName (First, Last)(Required) Contact Email(Required) Contact Cell Phone Number(Required) Event DetailsName of Event(Required) Date(s) of Event(Required) Start Time of Event(Required) End Time of Event(Required) Anticipated Number of Participants(Required) Space(s) Requesting for Event(Required)GymnasiumDining HallTheaterLibraryPhoenix Student CenterCollege Counseling Conference RoomFarmhouse Conference RoomAdministration Wing Conference Room (“The West Wing”)Classroom(s) – Please be specific belowSpecific Classroom Details(Required) Materials and Equipment Requesting for EventTables NeededNoYesNumber of Round Tables Number of Rectangle Tables Chairs NeededNoYesNumber of Chairs from Dining Hall Number of Chairs from Gymnasium Desks NeededNoYesNumber of stationary desks and chairs Number of desk/chair combinations on wheels Speakers NeededNoYesMicrophone NeededNoYesPodium NeededNoYesVideo Screen NeededNoYesProjector NeededNoYesLarge Garbage Cans NeededNoYesNumber of Large Garbage Cans Sports Equipment Needed (access to equipment room is not permitted)NoYesList specific equipment Parking Attendants/ MPH MaintenanceParking Attendants RequestedNoYesNumber of Attendants needed Time Attendants are needed Request for MPH Maintenance & Cleaning Staff to Set-up & Tear-Down EventNoYesSet-up needs to be completed by this time Tear-Down can begin at this time Space SetupSubmit diagram of space set-upAccepted file types: jpg, gif, png, pdf, Max. file size: 50 MB.Please submit a diagram if available. FoodRequest for Food at EventNoYesRequesting Brock Food Service to provide food/beverageNoYesRequesting to provide own food/beverageNoYesContact Brock Food ServicesContact Health and Safety Team
