Facilities Request Form - External Request | Lehigh Carbon Community College

Organization/Group Name: *

Organization/Group Address:

Contact Name: *

Contact Email: *

Contact Phone Number: *

Location (Site): *

Schnecksville

Morgan

Donley

Carbon

Title of Event: *

Description of Event: *

Start Date of Event: *

End Date of Event:

Please fill in end date for a multiple day event or meeting.

Day of the week: *

Event Start Time: *

:

am

pm

Event End Time: *

:

am

pm

Access to Room (include preparation time): *

Additional Information (varying start/end times on the multiple dates:

Posted on Video Marquees: *

Yes

No

Estimated Attendance : *

Specific Room Requested (if available):

Room Set-up: *

Yes

No

Setting: *

Classroom-Style Setting

Lecture-Style Setting (chairs only)

Round Table(s) - CSC Building Only

Extra:

Podium

Stage

Dance Floor

Explain Needs (specify):

Audio-Visual: *

Yes

No

Equipment:

Video/DVD

Sound/Music

Projection of Media

Access:

Internet

Computer Applications

Drive/Data/Flash Drive Data

Wireless Services: *

Yes

No

How many people need access:

Food Service: *

Yes

No

Meal Type :

Breakfast

Lunch

Dinner

Break/Snack

Specify, if more than one meal:

Service Setting:

Sit Down Meal

Buffet

Box Meal

Alcohol Served:

Yes

No

Type Alcohol Served:

Beer

Wine

Liquor/Mixed Drinks

Tablecloth Request:

Yes

No

Explain Needs for Food Service Set-up: