Application For Series Reservation
Organization
*
Today's Date
Contact Person
*
Phone Number
*
E-mail
*
Address
*
City
*
State
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AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Country
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Abkhazia
Afghanistan
Aland
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina Argentina
Armenia
Aruba
United Kingdom Ascension Island
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
People's Republic of China
Republic of China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
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Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
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Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana Guyana
Haiti Haiti
Honduras
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Hungary
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Indonesia
Iran
Iraq
Ireland
Israel
Italy
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Kenya
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Libya
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Lithuania
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Macau
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Malaysia
Maldives
Mali
Malta
Marshall Islands
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Mauritius
Mayotte
Mexico
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Mongolia
Montenegro
Montserrat
Morocco
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Namibia
Nauru
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Netherlands
Netherlands Antilles
New Caledonia
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Niue
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Palau
Palestine
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Paraguay
Peru
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Poland
Portugal
Transnistria Pridnestrovie
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
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Samoa
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Senegal
Serbia
Seychelles
Sierra Leone
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Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
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Spain
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Sudan
Suriname
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Swaziland
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
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Tonga
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Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
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United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Event Details
Date of Event
Title of Event
*
Type of Event
*
Single Room Meeting
Multi Room Meeting
Wedding
Lunch Dinner
Event Time (Start)
*
Event Time (End)
*
Setup Style
Classroom
Conference
Dining
Theatre
Equipment Needed
TV/VCR/DVD
A/V Screen
Computer
Data Projector
Overhead Projector
Coat Rack
Stage
Microphone
Easel
Lectern
Flipchart Stand
Registration Table
Other (we will contact you)
1st Room Preference
*
2nd Room Preference
Are Breakout Rooms required? If so, we will contact you to make appropriate room selections
Yes
No
(Every effort will be made to honor requested room preferences, yet a different room may need to be assigned when unusual circumstances or conflicts warrant)
Disclaimer
1. All groups must comply with University Union policies, university regulations, federal, state and local laws.
2. Requests received less than 7 days prior to meeting date, may not be accomodated.
3. Confirmation of room reservations will be emailed to the individual making the request.
4. Special set up of rooms and/or equipment must be confirmed no less than 3 days prior to event.
5. If excessive clean up is needed in a room, clean up costs will be charged to the group making the reservation.
6. Food may not be allowed in spaces assigned; please check before bringing food into any assigned area.
7. I voluntarily indemnify and hold harmless the University of Wisconsin-Green Bay, the Board of Regents of the University of Wisconsin Sytem, their respective officers, employees, and agents from any and all liability, loss, damages, costs, or expenses (including attorney fees) arising out of my participation in the Program and which do not arise out of the negligent acts or omissions of an officer, employee or agent of the University and/or Board of Regents while acting within the scope of their employment or agency.
I HAVE READ THE GUIDELINES ABOVE AND AGREE TO THE TERMS STATED
*
I AGREE