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Note: Only Club Executives Should submit this form
* indicates a required field.
Contact Information
*Name of Organization:
*Person Submitting This Form:
*Contact During the Event:
*Event Contact Phone Number:
*PSU E-mail Address:
*Advisor who will be present during the event:
*Advisor's PSU E-mail Address:
Event Information
*Event Title:
*Event Date (mm/dd/yyyy):
*Event Start Time:
*Event End Time:
*Set-up Time Needed (hours):
*Maximum Anticipated Attendance:
*Is this event Open to the Public? Yes No

*Room Requested (e.g. 207 Main):

*Second Choice Room:
Description of the event:
Publicize on Campus Events Calendar: Yes No
Audio visual and computer equipment
Two weeks advance notice required (e.g. overhead projector, video projector, laptop, etc.)
Special Requests
(e.g. ice, trash cans, picnic tables)
This section is not to be used to indicate desired room arrangement.
Room arrangements should be communicated directly to the Office of Physical Plant.
*Will this event present information, whether oral, written or visual, which may be perceived as sexually explicit or graphically violent?
Yes No
If yes, please explain the nature of the sexually explicit or graphically violent material:
Budget Information
*Will this event use SGA or Student Activity Fee Funding?
*Will any of the organizations involved be posting flyers or hanging banners to pubilcize this event?
Yes No
In considering the assignment of space, University funding, or the approval of publicity, including banners, for student activities involving sexually expicit or graphically violent material, consideration shall be given to general standards of decency and respect for the diverse beliefs of members of the University Community, including whether the content of the activity, or its publicity is lewd or obscene.
I have read and agree to abide by the policies and procedures for event reservations and campus publicity. There should be no contracts or publicity until approval has been received from the Student Affairs Office.