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Myers Alumni Center Rental Request Form Please complete this reservation form and submit at least 30 days prior to the date of the event. * indicates required fields for successful completion of form. * Contact Person _______________________________________________________________ * Phone Number (including area code) ______________________________________________ * Cell Phone Number (including area code) __________________________________________ * E-mail Address: _______________________________________________________________ * Billing Address: _______________________________________________________________ _____________________________________________________________________________ * Sponsoring Individual, Organization or Department: ___________________________________ Check all the following boxes that apply (At least one box must be checked):

This request is for a UC alumni and/or faculty/staff event

This request is for a UC student organization event

This request is for another group and/or individuals not listed above * Event Name: __________________________________________________________________ * Brief Event Description: _________________________________________________________ * Day(s) & Date(s) Rental Requested: _______________________________________________ Contact Person at Event to Greet & Direct Guests: _____________________________________(A contact person must be present at all times) * Name of room that is being requested Check all that apply (at least one box must be checked):

Alumni Hall Hunter Room

Boardroom

Courtyard

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Table & Chair Requests for Room Set-up: # of chairs ______ of 5-foot round tables ______ of 5-foot rectangular tables ______ * Equipment Needed (at least one box must be checked): (You must make your own arrangements for any equipment not listed above. After set-up, the renter will have responsibility of running and maintaining the equipment throughout the duration of their event.)

None Needed Podium Screen LCD (Alumni Hall) Piano Microphone Television (Alumni Hall)

Will you have entertainment? Y N (If yes, please be aware that we do not have a dance floor; you will have to rent one separately.) If answered yes, indicate type of entertainment (DJ, Band, etc.): ___________________________ * Number of event attendees: ______________________________________________________ * Will a caterer be used? Y N If yes, indicate the name of your caterer: _____________________________________________ * Will alcohol be served: Y N (If yes, a liquor permit is required) Catering Set-up: (please check one) None Buffet Stations Contact person and/or caterer will arrive for set-up at ________ * Event begins officially at ________ and will end at approximately ________ * Cleanup and breakdown will be completed by: _______ Special Instructions: _____________________________________________________________ _____________________________________________________________________________ For University-sponsored events, will security be required? Y N How did you hear about us? _____________________________________________________________________________

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I have read and understand the General Policies set by the UC Alumni Association for rental of the Myers Alumni Center as provided. I understand that any violation of these said policies and guidelines will be the responsibility of my department/organization and will result in reparation if necessary. I agree to these policies and guidelines. Print Name __________________________________________________________________ Sign Name __________________________________________________________________ Date _______________________________________________________________________ FOR OFFICE USE ONLY Approved ____________________________________________Date______ *If you are unable to electronically sign the form please, print off, sign and fax to 513-556-3011 attention: Diana Miller, subject: Rental Agreement Form. *You will receive a notification from the UC Alumni Association to let you know whether this request has been approved or denied.