Please download the Reservation Form (you may use the attached PDF document, or print/copy and paste the form below) and send via fax to: (617) 373-4915, or via email as an attachment to: k.jackson@neu.edu

Please do not advertise or promote your requested event until you receive a confirmation email.

Thank you!

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Today's Date: __________________________________________

Event Date: ____________________________________________

Title of Event: __________________________________________

______________________________________________________

Description of event: ____________________________________

______________________________________________________

Estimated Attendance: ___________________

Open to the Public:  Yes ___   No ___

Admission Charge:  Yes ___  No ___

Facility to be reserved (check one):

Cabral Center ___
Conference Room ___
Library ___
Classroom ___

Reservation Time:

___________________ to  ___________________

Event Time:

___________________ to  ___________________

Sponsoring Organization: _________________________________

Dept. Head/Advisor: _____________________________________

Name of Requester (print and sign):

______________________________________________________

______________________________________________________

Day Time Phone: ________________________________________

Evening Phone: _________________________________________

Local Address: __________________________________________

SET-UP (check one)

Theater/Auditorium: ___   # Chairs ___
Circle: ___   # Chairs: ___
Banquet: ___#   (round tables seat 8-10) ___
Reception : ___
Other: ___________________

EQUIPMENT (check all that apply)

Podium: ___
Microphone: ___
Chairs: ___
Tables: ___
Platform: ___
Projector: ___