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Name*

Rank

Organization

Email*

Phone

How did you hear about us?*

Brochure

Email

Newsletter

Social Media

Word-of-mouth

Other

What course(s) would you like to know more about?* Civilian Supervisory Series Emotional Intelligence Health, Wellness, and Resiliency Leadership 1: Intro to Org Mgmt Leadership 2: Intro to Leadership Leadership 3: Foundations of Leadership Leadership 4: Executive Leadership Media and Public Communications Sergeant Leadership Series Supporting First Responder Family

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Customer Type* Please Select UNTD Department Student Organization External Customer

Name of Event*

Event Type* Please Select Academic Administrative Athletic External Faculty Student Recruitment

Event Date and Start Time*

Event End Time*

Estimated Attendance*

Schedule/Agenda

Food or Catering Needed?*

Yes

No

Event Contact Information

Name*

Title*

Department/Organization*

Phone*

Email*

Room and Resources

Setup Type* Please Select Classroom Style Conference Style Theater Style (chairs only) U-shaped Banquet Style (round tables) Other (explain below)

If other, please explain

Audio-Visual Equipment Needed None Computer Projector Microphones Podium Sound System Guest Codes for Wifi Presentation Clicker Web Conference Record or Live Stream

Preferred Location* Please Select Dal 1 Classroom (30 seats) Dal 1, 102 Lecture Hall (70 seats) Dal 1 Lobby (20 tables max) FH Lobby (20 tables max) FH Classroom (40 seats) FH 101 Lecture Hall (90 seats) FH 138 (140 seats, theater style) FH Plaza (outdoor space) Computer Lab Conference Room Soccer Field Basketball Court

Second Choice Location* Please Select Dal 1 Classroom (30 seats) Dal 1, 102 Lecture Hall (70 seats) Dal 1 Lobby (20 tables max) FH Lobby (20 tables max) FH Classroom (40 seats) FH 101 Lecture Hall (90 seats) FH 138 (140 seats, theater style) FH Plaze (outdoor space) Computer Lab Conference Room Soccer Field Basketball Court

Will media be covering this event?*

Yes

No

Are you serving alcohol?*

Yes

No

Will off-campus guests be attending?*

Yes

No

Will minors be attending?*

Yes

No

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