Internal Request Form

INTERNAL FACILITY USAGE CONTRACT
DEPARTMENT: __________________________________________________________
PRIMARY CONTACT: _________________________________________________________________________________
PHONE: ____________________ FAX: ___________________ EMAIL: ___________________________________
IS THIS A SAN JUAN COLLEGE SPONSORED/AFFILIATED EVENT? Yes No
NAME OF MEETING/EVENT: ___________________________________________________________________________
ANTICIPATED NUMBER OF PEOPLE EXPECTED TO ATTEND: _________
TYPE OF FUNCTION: Meeting Conference Fundraiser Student Activity Event (Please provide the approved Student
Activities Proposal Form with your request)
IS EVENT OPEN TO THE PUBLIC? Yes No
PLEASE DESCRIBE IN DETAIL THE EVENT YOU ARE HAVING (PURPOSE OF EVENT): _______________________________
___________________________________________________________________________________________________
Arrival time: _______________a.m. p.m.
Exit time: ________________a.m. p.m.
Day of the
Week
Month
Date
Year
Starting Time
Ending Time
Room
Assigned
Use the attached “Additional Meetings” sheet to list more meetings, and include with facility contract.
ROOM TYPE: Conference Room-Seats up to 80 Seminar Room-Seats 24-40 Lecture Hall-Seats up to 130
Classroom Computer Lab Little Theatre*-Seats 333 Performance Hall*-Seats 744 Any
*Attached “Tech Sheet” must accompany Facility Contract when requesting the Little Theatre or Performance Hall. Use ATTACHMENT C for
a lecture type event, and ATTACHMENT D for a concert/play/etc. type event.
ROOM NUMBER/NAME PREFERENCE, IF KNOWN: _______________________
HOW MANY ROOMS ARE NEEDED? _________
SETUP STYLE:
Classroom (chairs/tables)
Theatre (chairs only) Banquet (chairs on both sides of tables)
Horseshoe
Round Tables
Other: Attach drawing
Serving Table(s) - How many? ___ Head Table(s) - How many chairs? ___ Display Table(s) - How many? ___
Reg. Table(s) - How many? ___
OTHER Setup requirements: _______________________________________________________________
MEDIA EQUIPMENT:
NONE Podium/Mic Display Easel DVD/VCR Combo Whiteboard Flipchart DocCam
Laptop Video Projector Screen Other: _____________________
Will admission fee or participant fees be charged? Yes No
Ticket prices: Child $______ Student $______ Adult $______ Senior Citizen $______
Will any items be sold? Yes No Describe: _____________________________________________________________
Will booth or table charges be assessed? Yes No
Is catering planned for this event? Yes No If yes, contact Mary’s Kitchen at 566-3155. (No outside catering is
allowed. This does not apply to potlucks provided by the SPONSOR and APPROVED by the COLLEGE).
Is extra Security requested? Yes No
X SPONSOR Signature ___________________________________________
XDate _______________________
COLLEGE approved: _______________________________________________ Date: _______________________
This form is only an application. Reservations are official ONLY when the approved copy of this Agreement and all
relevant attachments are returned to the SPONSOR.
Please return this form to:
Alana in Scheduling Services by Fax (566-3192) or Scan/email to [email protected]
OFFICE USE ONLY: Res.#: _________________________
Date Received: _________________
ATTACHMENT C
TECHNICAL ASSISTANCE RESERVATION FORM
LECTURE/BASIC PACKAGE EVENT
Name of Event: _________________________________________________________________________________
Program Date______________________
Program Time_____________
Access Time_________
Rehearsal Dates______________________
Rehearsal Times____________
Access Time________
Ticket Prices: (General) ______________ (Child) _________________ (Discount) _______________
Contact Name: _______________________________
Phone Number(s):___________________
For technical assistance please contact the SJC Technical Director: Linann Easley at (505) 566-3462
STAGE EQUIPMENT REQUIREMENTS
Some services below will go beyond the Basic User Package. If so, the technical director will advise SPONSOR of any
additional fee requirements.
Projection
Projection Screen_________
Projector________________
DVD:________ VHS:________
Laptop: Please provide
MAC PC
Will bring
Sound
Microphone:___________
Microphone Stands:_________
Hand Held Microphone:______________
Lapel Microphone:________________
On-stage monitors:______
Cassette:__________________ CD:__________________
Other
Speaker Lectern:________
Chairs: __________
Table: __________
With microphone: Yes No (attach diagram of setup)
Skirted Table: ___________
I understand that there will be no food or drink permitted in carpeted lobbies:
_________________________________________________________SPONSOR signature
Hall Fee: ______________
Technical Fee: __________
([email protected] hour per theatre monitor)
Total Due: ______________
Official Use Only
Tech Approval
Hall Approval
Ad-Astra
Payment Received
ATTACHMENT D
TECHNICAL ASSISTANCE RESERVATION FORM
CONCERT/PERFORMANCE PACKAGE EVENT
Name of Event: _______________________________________________________________________________________
Program Date____________________________ Program Time__________________
Access Time___________________
Rehearsal Dates___________________________ Rehearsal Times________________
Access Time___________________
Ticket Prices: (General) _________________
(Discount) _________________
(Child) ____________________
Contact Name: _________________________________ Home: _________________________ Work: ___________________
Mobile: ________________________ Fax: _____________________
STAGE EQUIPMENT REQUIREMENTS
Some services below will go beyond the Basic User Package, additional charges will apply.
Projection
Projection Screen_________
Projector________________ DVD:________ VHS:________
Laptop: Please provide
Will bring
MAC PC
Sound
Microphone(s):___________
Microphone Stand(s):_________
Hand Held Microphone: ______________
Lapel Microphone: ________________
On-stage monitors: ________ Cassette: __________________ CD: __________________
Snake: ___________ @ 50.00 ea
Drum Mics:________ @ 75.00 pkg
Lighting:
General Flood: ______________ Specific (lighting plot attached_:
Follow spot(s): ______________
(Hang & Focus @30.00hr)
Other (attach diagram and set-up):
Speaker Lectern: ________
With microphone: Yes No (attach diagram of setup)
Chairs: __________
Table: ____________
Skirted: Yes No
Choral Risers:___________
Band Risers:___________
9”Grand___________ Baby Grand__________
Upright Piano__________
@75.00hr
@50.00hr
Music Stands: ___________
Crew:
(Final determination of crew number by Technical Director)
Load-in: _____________ @18.00hr
Stage Manager: _____________ @18.00 hr
Follow spot(s):_____________ @18.00 hr
Projectionist: __________________ @18.00 hr
For technical assistance please contact the SJC Fine Arts Director:
Linann Easley @ 505-566-3462
San Juan Colleges maintains a maximum decibel level of 90.
San Juan College does not provide Ampliphiers or DI-boxes.
San Juan College strictly forbids: fog, smoke or other pyrotechnics.
SPONSOR is strictly prohibited from operating any SJC lighting and audio equipment.
If sponsor desires any music equipment, they must contact the SJC Director of Music 3 weeks prior to event @ 566-3386.
I understand and agree to follow the above San Juan College rules and procedures.
I agree to pay all fees generated by this event.
I understand that there will be no food or drink permitted in hall, on stage, or carpeted lobbies:
_________________________________________________________SPONSOR signature
I understand I must provide San Juan College, with a copy of my 1,000,000 event insurance policy listing San Juan College as an additional
insured no later than 3 weeks prior to event.
_________________________________________________________SPONSOR signature
ANY EQUIPMENT NOT REQUESTED ON THIS FORM WILL NOT BE PROVIDED!!!!!
Fees:
Hall Fee: ______________
Technical Fee: _____________
Additional Fees: ____________
([email protected] hour per theatre monitor)
$0.00
Total Due:______________
Official Use Only
Tech Approval
Hall Approval
Ad-Astra
Payment Received
ADDITIONAL MEETINGS
Organization:
Time
Room
SETUP
OFFICE USE ONLY
DATE
Reservation #: