Texas State University–San Marcos

11^th Floor J. C. Kellam Reservation Request

Event:

Reserving Party: Date of Request:

Room Requested: Reed Parr Room Regents’ Room

Is this event by invitation only? open attendance?

Month

Day

Year

Event Start Time

Event End Time

Decorating Time Start

Decorating Time End

Estimated Attendance

Date(s) Requested

FOOD OR BEVERAGE

Yes No

Note: The University contracted food service must cater events in the Reed Parr Room. (Chartwell’s @ 245-9900)

ALCOHOL: Yes No

Note: An Alcoholic Beverage Activity Form must be completed and approved. Chartwell’s is the exclusive provider of alcoholic beverages.

Equipment:

____Podium with Microphone - $15 ____Lavalier Microphone - $15 ____Handheld cordless Microphone - $20

____AV Podium - $25 ____ Piano - $75 ____ Dance Floor (6 ft. X 7 ft.) - $30

Other: No special set ups are available in the Regents’ Room. A room diagram must be submitted for the Parr Room. Other charges may apply.

Estimated charges: If University event, please provide the account #:

Rental fee: Cost Center ____________ Fund____________

Guard fee: _____________ $30 hr. min./4 hrs. per guard

Security fee: $40 hr. min./4 hrs. per officer Name of Account: _________________________

Equipment:

Set-up: $15 per hr. per staff Account Manager

Other: Approval:_________________________________

Estimated total:

Address: Phone #: _____________________

Signature of reserving party or advisor Contact person if different

__________________________________________________________

Student Organization – Dean of Students Approval

J. C. Kellam Building is ADA accessible. If you have special needs due to a disability, please call 245-2244.

University offices reserving JCK should contact the Office of Disability Services if sign language interpreting services are needed.

Return Form to: VPFSS Office, 601 University Drive, JCK 920, San Marcos, TX 78666 Fax: (512) 245-2033

Reservation confirmed by: Date:

UPPS 08.01.15 - Attachment II