MCC and BH Reservation Request Form

This form is submit requests for space in the Multicultural Center (MCC) and the Black House (BH). Submitting a request does not serve as an official confirmation of a room request reservation. All requests are subject to review. Please allow MSA staff respond at least 1 week to respond to your request. Email msa@northwestern.edu with any questions you have.

Name of primary contact for reservation. Name of primary contact for reservation. First Last
Email of primary contact
Phone number of primary contact Phone number of primary contact - ### - ### ####
Name of Event or Program for Reservation
Briefly describe your event or program
By checking this box I acknowledge that the purpose of the reservation request aligns with the mission, history and legacy of the Multicultural Center and/or the Black House.

By checking this box I acknowledge that the purpose of the reservation request aligns with the mission, history and legacy of the Multicultural Center and/or the Black House. I acknowledge
Estimated Attendance Number
Date of event Date of event / MM / DD YYYY
Start time of reservation (including setup time) Start time of reservation (including setup time) : HH MM AM/PM
End time of reservation (include clean up time) End time of reservation (include clean up time) : HH MM AM/PM
If you are requesting more than one date, click yes

If you are requesting more than one date, click yes Yes
Add additional dates and times here
Building Space Preferred
Rooms Requesting in the Multicultural Center

Rooms Requesting in the Multicultural Center MCC Lobby (100) - Soft seating for 6 Livingroom (101/102): Soft seating for 10 Multipurpose room (107): Table with 12 chairs; white board; TV with HDMI input Student Workroom (203/204): Table with 8 chairs; armchair; TV with HDMI input Student Group Meeting Room (306) Table with 6 chairs; whiteboard; TV with HDMI input Study Room (303): Table with 4 chairs; whiteboard Tabling Space MCC (100): Table with seats for 4 people
Rooms Requesting in the Black House

Rooms Requesting in the Black House Quibbler's Club Family Room (101): Soft seating (couches and armchairs) for 10 to 12; table with 4 chairs; TV with HDMI input; access to front porch Gathering Room (103): Table with 14 chairs; access to back deck; kitchenette (fridge and sink); open space (no doors) B100 Student Lounge (201): Soft seating (couches, armchairs, and beanbags) for 10 to 12; TV with HDMI input Conference Room (202): Table with 6 chairs; TV with HDMI input Board Room (301): Table with 10 chairs; TV with HDMI input Group Study Room (304): Table with 4 chairs; TV with HDMI input Tabling Space BH (103): Small table with 2-4chairs
By checking this box, I acknowledge that I am responsible for post-event clean-up and returning the space and furniture to its original place.

By checking this box, I acknowledge that I am responsible for post-event clean-up and returning the space and furniture to its original place. I acknowledge and I agree