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Facilities Reservation Request Form
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Office of Facilities Reservations 
WA 977

Phone: (510) 885-3681
Fax: (510) 885-4681

   
HELP FEATURE - CLICK HERE

NOTE:  * denotes required field. 

  Event Name*: 
 Anticipated Attendance*: 
Event Start Date*:
 
(please enter additional dates in  Other Special Request text box below if needed)		 Location(s) and/or Room(s): 
Event Start Time*: 
(00:00 AM/PM)		 Event End Time*: 
(00:00 AM/PM)
Start Setup Time: 
(00:00 AM/PM)		 Cleanup End Time: 
(00:00 AM/PM)
Equipment Needed: 
 Department Account # (must enter a real acct. # if equipment is needed):

(For on-campus use only)
Alcohol Served:   Yes No
Food Served:   Yes No
Organization/Department*: 
Requester's Name*: 

Responsible Person: 

Requester's e-mail*:
 Street: 
City: 
State:   Zip code: 
Phone*: 
                  000-000-0000
Other Special Requests (Including additional dates and/or times): 
Today's Date:  

       

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