Please use this form if you are planning an by Noodlezs

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									                                           PA Reservations Request Form
                                           For Performing Arts Spaces                                     Date Rec’d________
                                           To Schedule an Event Please return this form to:
                                           5500 N. St. Louis Avenue * University Events C-527
                                           (773) 442-4270 *E-mail – University-Events@NEIU.EDU
Version 10/31/06

Please use this form if you are planning an event involving the use of a Performing Arts Facility (The Auditorium or Recital Hall).
Please note that completing this form does not guarantee a facility reservation. It is used to initiate the request
process. The Student Union Space Administrator will review the form and determine whether or not the reservation can
be made. Expect to be contacted shortly after the Student Union staff receives this form. Please call 773-442-4631 if you
have any questions or concerns.

Organization/Department:                                         Today’s Date:
Name of Requestor:
E-mail Address:
Phone:                              Cell Phone/Pager:                                     Fax:
Mailing Address:

Name of Event Coordinator (or person responsible for event planning details):                                   Same as Requestor
E-mail Address:
Phone:                                                Cell Phone/Pager:                            Fax:
Mailing Address:

Event Name:

Event Type (check one):
  Single Dance Performance            Multiple Related Events: Check below & list details on page 2             Convocation
  Single Music Performance                 Multiple Music Performances                                          Juried Exams
  Single Rehearsal/Sectional               Multiple Dance Performances                                          Master Class
                                           Multiple Rehearsals/Sectionals                                       Recording Session
  Other:                                   Multiple Other:                                                      Seminar

Location (check one):
  Auditorium                                 Recital Hall                                 Other:

Date(s) and Time(s) Requested (Use table on page 2 to list multiple events)
Event Date(s):                                        Alternate Date(s):

Event Start:                        Event End:                      For Office Use Only

Access Time Begin:                  Access Time End:                Reservation Begin:                 Reservation End:

Set-up Time Required:               Breakdown Time Required:               (If unknown, please contact Auditorium Manager, ext. 4621)

Requested Stage Setup (included needed quantities):
   Chairs:                     Choral Risers / Platforms:              Dance Floor            Harpsichord              Other:
   Music Stands:               Concert Grand Piano:                    Upright Piano          Acoustic Shells


   Audio Visual Support (check all that apply; describe details on separate sheet)

   P.A System (amplified instruments/voice)                 Audio Recording                           Video Recording
   Podium/microphone                                        Video/Slide/computer Projection           Audio Playback
                                             PA Reservations Request Form
                                             For Performing Arts Spaces                                 Date Rec’d________
                                             To Schedule an Event Please return this form to:
                                             5500 N. St. Louis Avenue * University Events C-527
                                             (773) 442-4270 *E-mail – University-Events@NEIU.EDU
Version 10/31/06

Page 2
   Admission Fee:                                 Box Office Staff Required            Funding Source:

Food and Alcohol:
Will a Reception be held with your event?                   Yes          No
Location of Reception:
Is Alcohol being provided at your event?                    Yes          No

Estimated Attendance:
Audience:
    University Community             University Faculty/Staff        Non-University(please describe):
    University Students              University Alumni               All Audiences

   Parking:           Artists only                Audience Only          Artist and Audience

Additional Comments, Special Accommodations, etc.:

Event Information for Box Office, Display Case, INFO Line and Nvision:
Event Sponsor:

Event Title:

Name(s) of the Performing Artist(s):

Date(s):

Times(s):

Location(s):

Admision Fee(s):

Program/composers:
Please use this table to list schedule for multiple related events: (attach separate sheet if necessary)
    Date           Location              Event Name               Event Time     Event Time      Access Time     Access Time
                                                                     Start          End             Start            End
                                            PA Reservations Request Form
                                            For Performing Arts Spaces                                     Date Rec’d________
                                            To Schedule an Event Please return this form to:
                                            5500 N. St. Louis Avenue * University Events C-527
                                            (773) 442-4270 *E-mail – University-Events@NEIU.EDU
Version 10/31/06

Page 3

General Information

Point of Contact – The Student Union Space Administrator will serve as your point of contact for all University services related to your
reservation (food service, audio-visual, etc.) Completing this form will enable our staff to contact various departments on your behalf.

Insurance – (for Non-University Sponsors) A Certificate of Insurance in the amount of at least one million dollars naming Northeastern
Illinois University and its Board of Trustees as the covered parties is required to confirm your event. The certificate must be submitted
at least 2 weeks prior to your event.

Additional Charges – Additional charges for labor, energy, security, parking, etc. may apply due to the timing and scale of your event.

Teleconference/Telecommunication – Please inform the Student Union Space Administrator if your event requires
teleconferencing/telecommunications support.

Non-Smoking –Northeastern Illinois University has adopted a formal policy on smoking to guarantee clean indoor air. Therefore,
smoking is not permitted in any University facility.

Alcohol – Non-University sponsors must have alcohol catered by the campus Catering Service. Please inform the Student Union
Space Administrator if you plan to have alcohol service at an event. University sponsors must receive approval by the President or
appropriate Vice President to have alcohol service at an event.

Food Service – Events held in the Student Union must be catered by campus Catering Service. The Student Union Space
Administrator will serve as your contact for catering. Sponsors are not permitted to bring food from outside sources to their events.

Payment – A Non-refundable deposit of 10% (of total charges) is required to confirm your reservation. Deposits are due at least 4
weeks before the event.

Events sponsored or co-sponsored by a University department/organization must be paid using a direct payment voucher (DPV). DPVs
must be received at least 2 weeks prior to the event.

Changes – please contact Student Union Space Administrator with any and all changes to event.

Cancellations – Cancellations should be submitted at least 4 weeks before the scheduled event. This enables us to reassign the space
to another organization/department. Failure to cancel your reservation at least 4 weeks before event may jeopardize your
department’s/organization’s ability to reserve space in the future.

								
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