Organization*Name of Event*Proposed Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Time* : HH MM AM PM End Time* : HH MM AM PM President*Contact Number*Organization Advisor*Advisor Contact Number*Organization Co-AdvisorCo-Advisor Contact NumberEmail* Enter Email Confirm Email Activity DetailsType of Activity Blood Drive Meeting Party Movie Fund-Raiser Membership Drive Band Banquet Concert Other Other (Please Specify)*Cost of Admission*Organization InsuranceName of Insurance CompanyPolicy NumberAgent NameTelephone NumberActivity LocationRequested Location*Alumni Multiplex - FoyerAlumni Multiplex - GymAlumni Multiplex - Stage Left Side RoomAlumni Multiplex - Concession StandAlumni Multiplex - Soccer FieldAlumni Multiplex - Locker RoomsStokes Health and Wellness Center - Board RoomStokes Health and Wellness Center - Multipurpose (Aerobic) RoomStokes Health and Wellness Center - ClassroomStokes Health and Wellness Center - Locker RoomsStokes Health and Wellness Center - Weight RoomKing Science Building - Upper Lecture HallKing Science Building - Lower Lecture HallKing Science Building - LibraryKing Science Building - ClassroomKing Science Building - AmphitheaterStudent Union - Main RoomStudent Union - Meeting RoomStudent Union - ChapelStudent Union - Concession StandOutside Facilities - Tennis CourtsOutside Facilities - Parking LotsOutside Facilities - Outdoor Basketball CourtsI understand and agree to abide by all Wilberforce University regulations and Ohio State laws in the staging of this activity.* I agree