Event Application Form Event Application Form Heading link Copy link Name of Organization * Required Name of Applicant First Last Address * Required Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Daytime PhoneEmail * Required Facebook Link Twitter Link Event InformationType of Event * Required Describe in detail the event and activities: * RequiredEvent Date * Required MM slash DD slash YYYY Event Start Time * Required : Hours Minutes AM/PM AM PM AM/PM Event End Time * Required : Hours Minutes AM/PM AM PM AM/PM What time would you like to enter the space on the day of the event? : Hours Minutes AM/PM AM PM AM/PM Will Setup/ Take-down occur on the day of the event?YesNoGuest(s)/ Participant(s) entrance time(s) each day:YesNoEstimated Attendance?Will registration ticket(s) or admission fee(s) be required to attend this event?YesNoStaging Information:Please indicate the quantity of equipment neededStage size(s): Table(s): Chair(s): Podium(s): Easel(s): Will entertainment be provided for this event?YesNoA/V Information:Please indicate the quantity of equipment neededVideo/ Projection Screen(s): Sound Monitor(s): Speaker(s): Power point w/sound capabilities: Video Monitor(s): Projector(s): CD/DVD Player(s): Internet Access:YesNoMicrophone(s) - Lavalier(s): Handheld Wireless: Handheld Corded: Are you interested to know more about our Audio & Lightining packages for your eventYesNoInformation will be provided by the Event Manager upon receipt of the Event ApplicationCatering:Will event be professionaly catered?YesNoLicensed Caterer Name: Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneWill alcohol be served at the event?YesNoOutside caterering company will be charged a 10% gross sales fee prior to the event. Would like to know more information about catering options at UIC Forum?YesNoFacility Information:Do you have any security concerns?YesNoNote: UIC Forum will make final determination on security personnnel.If yes‚ please describe: Will there be vendors selling merchansise?:YesNo(Contact Event Manager for more informaion)How do you plan to publicize the event? Note: You cannnot advertize your event prior to approval. Will there be live media coverage during the event? If yes‚ please describe:Would you link UIC Forum to promote your event on website calendar, Twitter, or Facebook ?: Please read all of the information herein before making any commitments for event services or equipment.Official Challenge PolicySubmitting this application is not confirmation to conduct your planned event. Confirmation‚ if granted‚ will be in the form of a UIC Forum Contract issued to the organization or person responsible for conducting the event. In addition‚ a hold is only tentative and is not confirmed until a signed University contract and certificate deposit is received and approved.PLEASE DO NOT SEND OUT NOTICES‚ PUBLICITY‚ INVITATIONS‚ ETC. Prior to receiving and executing a space agreement/contract.I understand that‚ if event-related information herein changes (i.e. performers‚ date‚ etc.) this application shall be invalid and a new application may be required. Any changes are to be made in writing. By initialing below‚ I acknowledge that I have read all the information contained in this application‚ understand it‚ and will abide by it. I also understand the date the Forum may be holding for me is tentative and that an application for an event does not constitute a University agreement.Date * Required MM slash DD slash YYYY Initials * Required Below math question is a check to prevent against spam emailsQuestion: 1+ 5 = * RequiredCommentsThis field is for validation purposes and should be left unchanged.