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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