Event Coordinator Name of Coordinator Department Email Phone Number Campus Address with 4-digit Mail Code Address Address 2 City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Co-sponsoring Organization Refreshments Please note that food or beverage is not permitted in the Geballe Room. You must also rent the Seminar Room if you plan on having any level of catering. Will there be food or drinks at this event? No Yes Event Information Please note that food or beverage is not permitted in the Geballe Room. You must also rent the Seminar Room if you plan on having any level of catering. When entering dates, please take into consideration the additional set-up and breakdown times. (ex: Event from 10am to 4pm would be entered 9am to 5pm) Input each day as a separate line. To add another day, please click on "add additional date" Name of Event Room Selection Geballe Room Seminar Room See availability calendar × Geballe Room (blue) Seminar Room (red) Dates Dates Start Date Start Date: Date Start Date: Time End Date End Date: Date End Date: Time AddRemove Add Add more items more items Equipment Podium Mic Wall-Mounted Camera LCD projector and screen Hand Held Mics (maximum 2) Lapel Mics (maximum 4) Chartstring Name of Department Account Fund? Department (Organization) ? Program? Chartfield1 (Project)? Chartfield2 (Flexfield)? (e.g., FN248) Terms of Service Terms I have read the Townsend Center reservation guidelines and agree to the conditions. I confirm that any food or drink items will be restricted to the hall and the Seminar Room, and that all clean-up, including removal of garbage, will be completed by the event’s end. I have read the Townsend Center reservation guidelines and agree to the conditions. I confirm that any food or drink items will be restricted to the hallway and the Seminar Room, and that all clean-up, including removal of garbage, will be completed by the end of the event. Submit