Facility Request & Speaker Form

Date and Time of the Event(*)

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Sponsoring Organization(*)

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Co-Sponsor (If Applicable)

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Contact Person(*)

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Job Title(*)

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Office Phone(*)

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Cell Phone(*)

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Email(*)

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Title and Description of the Event

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Number of People Expected(*)

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Number of Parking Spaces(*)

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Please Indicate if there will be Food and Beverages

Food Beverages Invalid Input

Vendor name and description of food and/or beverage

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Is Kitchen Area Needed?

Yes No Invalid Input

Event 1 Set Up Date and Time(*)

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Event 1 Program Start Time

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Event 1 Program End Time

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Event 1 Room Number(*)

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Event 2 Set Up Date and Time

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Event 2 Program Start Time

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Event 2 Program End Time

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Event 2 Room Number

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Media Services

Setup Options

If you have your own setup, please upload a PDF here.

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Number of Chairs Requested

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Number of Rectangular Tables Requested

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Number of Round Tables Requested

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Number of Podiums Requested

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Number of Coat Racks Requested

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Number of Panelists Tables Requested

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Additional Setup Information

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Please indicate how the room will be set up, the quantity of chairs/tables requested, etc.

Have you invited, or plan to invite, the press to this event? *

Yes No Invalid Input

If yes, which publication, radio and/or TV stations?

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Will you invite any politicians or state officials to this event? *

Yes No Invalid Input

If yes, who?

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Is the event open to the public? *

Yes No Invalid Input

Is there an admission/registration charge for the event? *

Yes No Invalid Input

If yes, indicate the amount

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Is an HCC speaker desired?

Yes No Invalid Input

If yes, please specify individual requested

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Would you like HCC academic promotional material at your event?

Yes No Invalid Input

I understand that submitting this request does not guarantee the reservation of room(s) or space(s) being requested. I will be notified of the approval by the division designee. Contact person is fully responsible for cleaning up after each event, including but not limited to, contacting caterers/vendors to ensure all catering and staging equipment is picked up and removed from HCC's facility the same day/night of the event. Materials remaining after event are subject to holding fee of $100/day. This Facility Request reflects the exact specifications intended for this event. Any adjustments or changes requiring the additional services of HCC's Facilities, Media, or IT Services beyond those specified herein are subject to expenses incurred and invoicing in addition to HCC's contracted price for this event.

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Event Planner ID

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Facility Request & Speaker Form

Facility Reservation Request Form