What is the Event or Program? ______________________________________________________
DATE of Event: ________________________
TIME of Event: From: ________________________ To: ________________________
Your organization or group? ________________________________________________________
Approximate # of people attending? ______________
Will participants be charged to attend? (If so please explain)______________________________
Facility needed (please check):
DSC Ballroom Rangerette Gym Masters Gymnasium DSC Conference Room
Dodson Auditorium Pool Carpeted Gym Aerobics Floor
Devall Room Other___________________________________________________________
Contact person for the event:
Name____________________________________________________________________________________
Phone Number or KC Extension ___________________ e-mail ______________________________________
Items needed: (free of charge if available) Lectern Piano American & Texas fl ags
Tables & Chairs:
# of Round Tables / Chairs? _______ / _______
# of Long Tables / Chairs? _______ / _______
# of Serving Tables / Chairs? _______ / _______
# of Registration Tables? ________
NOTE: Facility Coordinator will check the availability of the desired area. If it is available, it will be placed on the KC Master Calendar. Please submit requests in ample time to assure availability.
Internal Facility Request FormKC-Sponsored Events
Technical Items & Services Needed (Audio & Video)If you selected above that you need technical items such as PA systems, laptops or projectors, please fi ll out the information below. Technical items that are available are free to use, however some services, such as a lighting/sound technician will cost extra.
Do you need technical items and/or services for your event? Yes No
If you checked yes, please name the audio items needed below:
Use of Public Address (PA) System CD Player Other_________________________
Do you need a lighting/sound technician on hand?
Yes, I need a Lighting/Sound Technician No, I do not need a Lighting/Sound Technician
If you checked that you need a PA System, please fi ll out the information below:
What type and what quantity of microphones & equipment do you need?
Wireless microphone – quantity_______________ Lapel microphones – quantity_________ Microphone (regular) stands – quantity_________ Direct (DI) Boxes – quantity___________ Microphone (boom) stands – quantity__________ Instrument Hook-ups – quantity________ Other Items (specify)_________________________________________________________________
Approximately how many feet of sound cable will this event require? ____________feet
Do you need video services and/or items for this event? Yes No
If you checked yes, please name the video items needed below:
Projector – quantity__________ Screen to project items on – quantity______________ DVD player – quantity___________ Laptop with PowerPoint – quantity________________
Video Camera – quantity_________
Approximately how many feet of video cable will this event require? ____________feet
If providing your own laptop, specify if it is a: Apple/Macintosh IBM (PC)
If you answered yes to Mac, do you have the proper adaptors? Yes No
Additional Notes for our department: _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________