University of Louisiana at Lafayette
Request to Use the LITE Center
For a University Event
1) Contact Name and Phone Number:
2) UL College/Department/Center:
3) Brief Description of the Event (Purpose, Who, What and Why):
4) Date(s) of the event:
5) Duration of the event including set up and take down (give duration of the event and
date/time of set up and take down):
6) Expected number of people in attendance:
7) Will alcohol or food be served? Yes No
If the answer is yes, you must complete a separate food/alcohol request form to be
approved by the Vice President for Research and Graduate Studies, and the President.
8) Has the LITE Staff confirmed date & time availability? Yes No
By my signature, I certify that I have read, understood, and intend to comply with all Terms and
Conditions of LITE’s Usage Policy. The requested use is for university purposes (meeting, conference,
workshop, research, demonstration, academic, etc.) only and is not commercial in nature. I understand
that failure to comply could result in loss of facility privileges. I further certify that my
department/center shall be responsible for all charges for this event for which I have arranged (e.g.
security, catering, etc.). Furthermore, by my signature, I agree that I or my department/center will be
responsible for any damages that may occur during use of the facility.
Signature (typed if filing electronically) Printed Name
Signature Printed Name
(Vice President for Research & Date: