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:  )

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