Providence Campus Facility Use Request

Please read notes before submitting this form

No setup changes will be made seven (7) working days prior to the event. This form is only a request and not a confirmation. This event will not be booked until you receive confirmation from a representative of the building operations staff. If you do not receive a confirmation within seven (7) working days from today's date, please contact The Scheduling Office at 401-277-5079. Please be advised that all outside agency coordinators must check in with security at the Washington Street entrance before the meeting begins.

Contact Name

First Last

Name

First Last

Phone*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Non-profit Number

Affiliation*

If other, please specify

Non-State entities please provide: *Certificate of Commercial General Liability Insurance in the amount of $1 Million, with the requester listed as the University of Rhode Island, and additional insureds listed as State of RI, and RI Council on Post-Secondary Education. *Non-profits, please submit copy of 501(c)3 designation.

Event / Group Name*

Day(s)*

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Dates*

Year*

Start Time*

:

End Time*

:

Number of Attendees*

Type of Room*

Parking Validation Needed?*

Yes
No

*Please note: Parking validation is for URI students/faculty/staff and URI-Sponsored events only. If you are an outside agency and wish to park at the RI Convention Center Parking Garage, please contact them directly at 401-458-6000.

AV Equipment Requested (you will be billed separately by the AV Department)*

If other equipment, please specify

Caterer's Name

AUDITORIUM SET-UP (if applicable)

There are three (3) tiers in the auditorium. Check one or more as needed.

Tier 1 (Closest to stage)
Tier 2
Tier 3

Number of Aisles

Number of round tables (tier #3)

Number of chairs at each table

Number of 6-foot rectangular tables

Six-foot table placement

If requesting all three tiers...

Other detailed setup instructions