Event Facilities Request

Walla Walla University
204 South College Avenue
College Place, WA 99324
(509) 527-2491
val.wren@wallawalla.edu

Contact Information:

Applicant’s Name

* Organization: * Contact Person:
* Street Address:
* City: *
* Zip/Postal Code: Email:
* Phone (day): * Phone (evening): Fax:

Event Information

* Description of Event:

* Will Food be served?

Yes

* Is this reservation for more than 1 day?

Yes

* What equipment is needed?

* Estimated Attendance:

* Type of room needed:

Classroom

Lecture Hall

Conference Room

Insurance

* Does your group/organization have liability insurance coverage?

Yes

If your group/organization needs to purchase insurance, you may purchase coverage from a web-based company, Clarendon Urmia Tulip Insurance (Tenants and Users Liability Insurance Policy). Before the Facility Use Agreement can be completed, you must purchase the liability insurance online and make payment directly to Clarendon Urmia Insurance. The insurance company will send Walla Walla University a certificate of liability insurance with an endorsement naming Walla Walla University as the additional insured.

Digital Signature

* I confirm that the above information is true and correct to the best of my knowledge.

By typing in your name and clicking on the "Submit" button below, you acknowledge your electronic signature and agree that all information you are providing to Walla Walla University on this application is true, complete and correct to the best of your knowledge.
Thu May 24, 2012 4:41 am

Please solve this problem (why?): five plus three equals
* Response required Form ID 215, created by FormIt 1.0