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WestM Room Reservation Request Form
**PLEASE NOTE THAT RENTAL RATES WILL BE CHANGING SPRING QUARTER 2018. CONTACT THE OFFICE MANAGER WITH ANY QUESTIONS REGARDING FUTURE RATE INCREASES AND/OR APPLICATIONS FOR A SLIDING FEE**
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* Indicates required question
Contact Person
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Your answer
Phone Number
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Your answer
E-mail Address
*
Your answer
Name of Group
*
Your answer
Name of Event
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Your answer
Purpose of Event
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Your answer
Room Requested
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McLean Room (large carpeted room, holds up to 76 people)
Student Lounge (smaller carpeted room w/ couches & recliners, holds up to 15 people)
Kitchen Use
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Yes
No
Date(s) Requested
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Your answer
Start Time
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Your answer
End Time
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Your answer
Any special arrangements or needs?
Your answer
Person responsible for payment (if different from above)
Your answer
Contact info for payment (if different from above)
Your answer
*
Please review the room use policy before submitting your request.
I have read and understand the Building Use Policy and the Room Use Policy.
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