(Any field marked with an * is required) 1. Person Requesting * Name * Address * E-mail * Phone (day) * Mail Location 2. Event Information * Name of Event * Sponsoring Department or Organization * Specific Purpose of Event * Expected Attendees (Select an Attendee) Faculty Staff Students Other 3. Choose a Room Preferred Room Space * Number Attending * Dates (mm/dd/yyyy) * Event Start Time * Event End Time * Start Time for Setup * Food Served Yes No 4. Event Open To * (Select one) Members Only All University Member & Guest Student & Faculty General Public # # Only educational and cultural events may be opened to general public 5. Financial Arrangements YesNoAmount * Admission * Registration * Donations * Items for Sale 6. Speaker Information * On Campus Speaker Yes No * Off Campus Speaker Yes No Name & Title Affiliation Title of speech * Preferred Publishing Calendar (Select one or more) Department Calendar Medical Center Calendar University Calendar None 7. Person Responsible * Name * Phone (day) Address * E-mail Position in Organization Mail Location * Affiliation: Academic Health Center UC East Non-COM UC West Other * Status: Student Faculty/Staff Non University 8. Billing Arrangements (if applicable) Send Bill To UC Sponsored Organizations Must Supply CUFS number I/ We acknowledge that the rules and regulations governing the usage of College of Medicine facilities. I/We acknowledge that my/our organization in the absence of posting a bond, will be financially responsible (1)for any damage caused by my/our use of Kresge Auditorium or College classroom; and (2) for any charges assessed by the College for services provided in connection with the above event. I/We also acknowledge that the COLLEGE OF MEDICINE RESERVES THE RIGHT TO APPROVE OR DISAPPROVE WITHOUT JUSTIFICATION THE USE OF ANY COLLEGE FACILITY. It is further acknowledged that the College of Medicine reserves the right to cancel the Agreement FOR USE OF KRESGE AUDITORIUM AND CLASSROOMS any time prior to the date of the scheduled event and that the undersigned and his/her/their organization will hold harmless the College of Medicine, the University of Cincinnati, and any of their employees for taking such action. I/We acknowledge that I/we received a copy of the SPECIFIC RULES AND REGULATIONS FOR THE USE OF KRESGE AUDITORIUM. I/We acknowledge and agree to adhere to the rules and regulations which govern the College of Medicine Facilities. Food / Beverage Policy No food or beverages are permitted in classrooms or Kresge Auditorium Comments Yes I understand (If this box is not checked, we will not be able to process your request). For assistance or comments, contact Jim Glenn at (513) 558-4186 or Matt Conley at (513) 558-4186 or E-MAIL
* Name
* Address
* E-mail
* Phone (day)
* Mail Location
2. Event Information
* Name of Event
* Sponsoring Department or Organization
* Specific Purpose of Event
* Expected Attendees (Select an Attendee) Faculty Staff Students Other
3. Choose a Room
Preferred Room Space
* Number Attending
* Dates (mm/dd/yyyy)
* Event Start Time
* Event End Time
* Start Time for Setup
* Food Served
Yes No
4. Event Open To * (Select one)
Members Only
All University
Member & Guest
Student & Faculty
General Public #
# Only educational and cultural events may be opened to general public
5. Financial Arrangements
Yes
No
Amount
* Admission
* Registration
* Donations
* Items for Sale
6. Speaker Information
* On Campus Speaker Yes No
* Off Campus Speaker Yes No
Name & Title
Affiliation
Title of speech
* Preferred Publishing Calendar (Select one or more)
Department Calendar Medical Center Calendar University Calendar None
7. Person Responsible
Address
Position in Organization Mail Location
* Affiliation:
Academic Health Center
UC East Non-COM
UC West
Other
* Status: Student Faculty/Staff Non University
8. Billing Arrangements (if applicable)
Send Bill To UC Sponsored Organizations Must Supply CUFS number
I/ We acknowledge that the rules and regulations governing the usage of College of Medicine facilities. I/We acknowledge that my/our organization in the absence of posting a bond, will be financially responsible (1)for any damage caused by my/our use of Kresge Auditorium or College classroom; and (2) for any charges assessed by the College for services provided in connection with the above event.
I/We also acknowledge that the COLLEGE OF MEDICINE RESERVES THE RIGHT TO APPROVE OR DISAPPROVE WITHOUT JUSTIFICATION THE USE OF ANY COLLEGE FACILITY. It is further acknowledged that the College of Medicine reserves the right to cancel the Agreement FOR USE OF KRESGE AUDITORIUM AND CLASSROOMS any time prior to the date of the scheduled event and that the undersigned and his/her/their organization will hold harmless the College of Medicine, the University of Cincinnati, and any of their employees for taking such action.
I/We acknowledge that I/we received a copy of the SPECIFIC RULES AND REGULATIONS FOR THE USE OF KRESGE AUDITORIUM.
I/We acknowledge and agree to adhere to the rules and regulations which govern the College of Medicine Facilities.
Food / Beverage Policy No food or beverages are permitted in classrooms or Kresge Auditorium
Comments
Yes I understand
(If this box is not checked, we will not be able to process your request).
For assistance or comments, contact Jim Glenn at (513) 558-4186 or Matt Conley at (513) 558-4186 or E-MAIL
