Events Form


** Indicates a required field

1) Requester Information

Requester Name**:
Requester Email Address**:

2) Department Information

Department Name**:
Cost Center/Fund Code**:
Administrator Sponsor/Reviewer (requesting services)**:
Box #**:
Phone #**:
Copy of JV Requested? Yes
Mail to:

3) Event Information

Event Name**:
Event Date(s)/Time(s):  
Date(s)
**


 Weekday
**


 From
**


 To
**


 # of Hours
**
Event Contact: Contact person present at the event
Name**:
Phone #**:
Email Address**:

4) Event Type** (check all that apply)

Athletic (includes races, walks, etc.)
Seminars/Speakers
Conferences/Demonstrations/Forums
Special Visitors/VIP's/Dignitary Visits
Social Party/Concert/Dance/Fundraiser
Other; explain:

If the event is a Social Party/Concert/Dance/Fundraiser, please check all that apply below:

Yes No  
Student Event
University/Medical Center Event
Charging admission /Cover Charge
      If yes:
Presale only Sold at the door
Duke affiliated only
Advertised to the public
      If yes:
Other Universities only General Public
Other Universities (four year collage ID required)
Alcohol Present
  If yes: University Bartender
Amplified sound
      If yes:
Live music | Name of Band/Artist:
DJ | Name of DJ:
Other | Type: Other
Party Monitors
  If yes: Monitors trained through Duke University Wellness Center
Professional Staff Present at the Event
Stage
  Event Reviewed by: Event Management (UCAE)
Res. Life
Advisor
Wellness Center

Location**:
Alternate Rain Location and Date:
Estimated Attendance**:
Brief Overview/Description of Event**:
Special Details/Needs/Instruction: