Winter Park Campus Room Request

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Faculty & Staff

Please complete this form at least five days prior to the event.

Event Information Fields marked with a red asterisk* are required
*Contact Person This field is required	Valencia ID
Facilitator’s Name (if other than requestor)
*Contact Phone This field is required	*Contact E-mail This field is required
*Event Title (will be placed on room sign) This field is required	*Purpose Please select an item
*Event Start Time (please use military time) This field is required	*Event End Time This field is required
*Date(s) This field is required	*Day(s) Please select an item
*Number of Attendees This field is required	*Type of Room Requested Please select an item
	“Smart Classrooms and Computer Labs may not always be available, even if requested in advance.
Comments / Special Needs
Note: Events are automatically allotted 30 minutes prior to, and after the event, for set-up and clean-up. If you need additional set-up or clean-up time, please note this in the Comments section above.

Room Configuration & Setup
A room configuration selection is required*

Please indicate the specific room arrangement you require. Add notes below in the 'Additional comments or information' section for clarification, if necessary.

Standard Classroom	Chevron	Circle (chairs only)	Conference
Doughnut	Pods	Semi-Circle (chairs only)	Theater (chairs only)
"U" Shape	Tables (indicate # of tables and chairs below)	Other- Upload:

*It is mandatory to attach a room diagram to this form if one of the above diagrams is not sufficient.

Comments / Special Needs

A/V Equipment, Supplies, or Special Needs
*Check all that apply, even if you are requesting a Smart Room or Computer Lab.

Kitchen Requests - Room 226A The checkbox in this section is required* only if you will be using the kitchen
I understand that the user is responsible for kitchen clean-up; including utensils, dishes, stove, counter, sink, and tables. The user agrees to provide dishcloths, towels, detergent, etc. Any food left in the refrigerator after the event will be discarded. Have you arranged for clean-up assignments within your department? Yes No Have you arranged for cupboard key(s) checkout? (Contact Amanda Body Hoaglen at x6874) Yes No It is mandatory for the caterer/vendor to remove all supplies and food from the campus directly after an event. Any food or supplies left by the caterer/vendor will be discarded at the end of the day

Checklist All fields in this section are required*
Checkbox required I understand that I am responsible for ensuring that all Valencia Community College policies, rules, and regulations are adhered to by my group. I further understand that I am responsible for the following: Have you marked your Audio/Visual needs listed above? Yes No N/A Please make a selection Will you need special security accomodations? (i.e. Reserved parking, busses, etc...) Yes No Please make a selection Please specify your security needs Have you contacted Food Services? (Contact Ashley Doyle with Cabin Creek at x2560) Yes No Other Please make a selection List your catering vendor’s name, contact information, and delivery/pick-up details. Is this a Collegewide or community-attended activity? (Contact CCR at x3125 and/or MMR at x1017) Yes No Please make a selection