Request-to-Host-an-Off-Campus-Group-at-Colby1

COLBY COLLEGE REQUEST FOR USE OF FACILITIES for Non-Colby Off Campus Groups (Must be completed in full BEFORE event can be approved by Academic Vice President and Scheduling Office) In order for a requested event using College facilities to be considered, the proposal must clearly demonstrate that the Colby host will participate centrally in organizing and hosting the event Requests for events that not have a central academic or research component will be considered non-Colby activities and may not be approved or may be subject to facility use fees and other conditions Requesting Faculty: _ Department: _ Phone: Specifics of Proposed Event Requested Event Title: _ Event Description: _ _ Proposed Date: _ Proposed Location: Proposed Hours of Event: _ Will a fee be charged to participants and, if so, what will the charge be: _ For what purpose will this money be used: _ What role will your department/students play? _Will you be directly involved and be on campus during the event requested? _ _ Will you charge a fee for your services or otherwise benefit financially? Please describe: _ _ How many guests will participate in this event? _ Their age range? Who will be responsible for supervision of minors under the age of 18? _ Event Requirements (please note, the College reserves the right to require certain staff/services be available during all events, at a fee payable by the sponsoring department or organization) Will Food be Served or Sold? Source of Food: _ (please note Colby requires all catering be provided by Dining Services) Physical Set-up Required: Grounds _ Custodial Security Media Services Account Number to Charge labor costs to: Account Number to Charge should damages or additional clean-up occur: _ Liability Insurance Please check if you or another organization will provide general liability insurance naming Colby as an additional insured and certificate holder (please list the name of the organization supplying insurance coverage ) Please check if you are asking the College to provide insurance for this event Signatures Required for Approval (Following requesting faculty and department chair/director signatures, please submit to scheduling for final approvals) _ Requesting Faculty/Staff Date: _ _ Department Chair/Director Date: _ _ Scheduling Manager Date: _ _ Academic Vice President Date: _ (Revised 1/28/2009)