Viterbo University - The University of Opportunity: Hope and Help


 Mathy Center Lease Request Form


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:  )



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 or 796-3120