ACSJL Reservation Request Form (COVID-19) – Arcus Center for Social Justice Leadership

Name *

Current Date *

Organization/Department if applicable

Email *

Check One: *

Faculty
Staff
Student

Other:

How many organizers/hosts plan to be present?: *

Event Details

Title of event: *

Time and planned duration of event: *

Date of event: *

We are only able to accommodate one event per week - please provide desired date first and, if possible, a few alternative dates if first is not available.

Provide a detailed description of your event (include speakers, agenda, format, etc.): *

Social Justice Issues Addressed by Proposed Event (Check all that apply):

What are the goals, outcomes, and/or action steps for participants?: *

How does this event connect to the ACSJL's work?:

Funding needs (if no funds are requested, please move on to the next section):

Total amount requested from ACSJL (typical support ranges from $100-$500): *

Expenses (include dollar amount and description for each individual expense): *

Supply needs (if no funds are requested, please move on to the next section):

Supplies Needed *

Tables (up to 10)
Standing white board + markers
Projector use + sound system
Two microphones
Lectern
Easels (up to 3)

Based on our event set up options listed on our information page, please indicate which supplies we have to offer you plan to use. Chairs and disposable cups are not listed here as all of them will be left available to you regardless. *Any item or piece of furniture not listed here is not for use even if it’s still physically in the space.*

Additional Information or needs:

Guideline Acknowledgements

Please take some time to read over our guidelines and building use during COVID-19 information before continuing.

Event capacity must remain below 25 people at all times *

I acknowledge

All individuals must be masked the entire time they are indoors *

I acknowledge

All individuals must maintain 6 feet from all other individuals at all times. *

I acknowledge

An ACSJL staff member will be in the building during your event, but is not required to leave the office wing at any point *

I acknowledge

Any event support and needs must be organized beforehand through Facilities Management, Media Services, or the Help Desk. *

I acknowledge

Catering and use of the ACSJL kitchen are unavailable *

I acknowledge

The 4 bathrooms near the East entrance are the only bathrooms available to guests *

I acknowledge

Set-up, sanitization, and tear-down are the event organizer’s responsibility *

I acknowledge

Campus Support - COVID

Event Details

Funding needs (if no funds are requested, please move on to the next section):

Supply needs (if no funds are requested, please move on to the next section):

Guideline Acknowledgements