Mathy Center Lease Request Form

The intent of this form is for facility usage requests with the exception of conference room reservations. To reserve a conference room, contact scheduling@viterbo.edu.

 

 

Application Date:    [None] Select a Date Delete the Date  

 

Basic Information:

Sponsoring Department / Organization: 

Contact:   Phone: 

Email:   Address: 

 

Event Information:

Activity / Event Name:           Type of Function:  

Estimated Attendance: 

Is this a one-time or recurring event?
(Example: A sports league is a recurring event if it occurs on multiple dates)

    

 

Start Date:   [None] Select a Date Delete the Date             End Date:   [None] Select a Date Delete the Date  

Start Time:                                 End Time: 

Set up Time:                              Teardown/Clean Up Time: 

 

Room Requests: (Indicate all that apply)

Click here for a map of the facility.

    

 

Additional Event Information:
(Use this space for recurring event dates and alternate date or location options for the event)
 

 

Event Requirements:

         (Quantity:  )         (Quantity:  )

Extra                 

     

Other Needs:   

University Departments / Groups Large Event Set up and Teardown:

    

If there are any questions, feel free to contact the Amie L. Mathy Center at mathycenter@viterbo.edu or 796-3120

 

      

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