New Game Room Event Request Form

1Event Information > 2Event Details
Name of Organization or Department
My organization is...

My organization is... A registered student organization A student affairs department An academic affairs department
Name of Program or Event
Form of Payment
Chartstring (please list full number)
Name Name First Last
Email
What space(s) are you looking to reserve.

What space(s) are you looking to reserve. The Game Room Nexus Gaming Lounge Both Spaces
Phone Phone - ### - ### ####
First Preference Date First Preference Date / MM / DD YYYY
First Preference Time First Preference Time : HH MM AM/PM
Second Preference Date Second Preference Date / MM / DD YYYY
Second Preference Time Second Preference Time : HH MM AM/PM
Third Preference Date Third Preference Date / MM / DD YYYY
Third Preference Time Third Preference Time : HH MM AM/PM