Contact and Payment Information

First name: Last name:

Identification Number (ID):

Address:

City:

State: Zip Code:

Phone (daytime): Phone (mobile):

Email Address:

Department to be billed:

IU Account Number:

IU Foundation Number:

Reservation Information

Date of Event:

Time of Event:

Please select the room that you would like to reserve: A218 / 2nd Floor / Capacity (15) A223 / 2nd Floor / Capacity (20) A233 / 2nd Floor / Capacity (15) Bridgwaters Lounge / 1st Floor / Capacity (50) Conference Room / 3rd Floor / Capacity (10) Grand Hall / 1st Floor / Capacity (165-dinner)(225-theatre)

Event Description:

Estimated Attendance:

Will you need us to provide any technology for your use? (please check all that apply)

• Microphone(s)
• Sound System
• Laptop
• Projector
• Podium
• Stage
• Other

Food and Alcohol Service Information

Will food be served? Yes No

Will you be working with a caterer? Yes No

Caterers’ name?

Will there be alcohol served? If YES, see policy section on the previous page. Yes No

Notes: (please include a description of your events and set up needs)