Internal UACCB Request Form

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IMPORTANT: 

Most of Independence Hall will not be available for reservations November 21 – December 23, 2022, due to technology system upgrades.  This includes the Auditorium, Banquet Halls, 103 Lecture Hall, and also includes the NAH 902 Lecture Hall.  

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Faculty/Staff Room Request Form for College Functions

Event Title / Description *

Event Date(s) *

Reservation Beginning Time (This includes time needed for setup) *

789101112123456 : 0030 AMPM

Event / Meeting Actual START Time *

789101112123456 : 0030 AMPM

Reservation End Time (Please include time needed for takedown and clean-up) *

789101112123456 : 0030 AMPM

Location(s) Requested *

Expected Number of Attendees *

Will food be served / catered? (Yes or No. If Yes, please list caterer/provider.)
[NOTE: We are under contract with Pepsi and must serve Pepsi beverages at college functions, including bottled water. Coffee and tea are exceptions.] *

Requested Room Setup / Technology Needs / Additional Requirements / Helpful Info for Setup or Needs

Sponsor Information

Division (Please select your Division - Department) * Please Select One: Division of Academics - Academic Services Division of Academics - Adult Education Division of Academics - AHEC Division of Academics - Arts and Humanities Division of Academics - Business, Technology, Public Services Division of Academics - Center for Teaching & Learning Excellence Division of Academics - Community and Technical Education Division of Academics - Distance Education Division of Academics - First Year Experience Division of Academics - Library Division of Academics - Math and Science Division of Academics - Nursing and Allied Health Division of the Chancellor - Chancellor's Office Division of the Chancellor - Development & UACCB Foundation Division of the Chancellor - Marketing & Communications Division of Finance and Administration - Bookstore Division of Finance and Administration - Business Office Division of Finance and Administration - Grill Division of Finance and Administration - Events Division of Finance and Administration - IT/Information Services Division of Finance and Administration - Maintenance Division of Finance and Administration - Vice Chancellor's Office Division of Research, Planning & Assessment - Institutional Research Division of Student Affairs - Admissions Division of Student Affairs - Advising Division of Student Affairs - Career Pathways Division of Student Affairs - Counseling Division of Student Affairs - Financial Aid Division of Student Affairs - Registrar Division of Student Affairs - Student Activities Division of Student Affairs - Student Development Division of Student Affairs - Student Success Center Division of Student Affairs - Student Support Services / TRiO Division of Student Affairs - Vice Chancellor's Office

Contact Person *

Email *

Extension # *

If you are human, leave this field blank.