Summer Camps and Conference Housing Request for Space

Name of Organization *

Purpose of Conference *

Contact Person *

Email Address *

Mailing Address *

Phone Number *

Fax Number *

Is your contact person the person who will be responsible for billing?

Yes

No

If no, please include contact information for the individual responsible for billing in "Special Needs" below.

Actual Conference Start Date *

Actual Conference End Date *

Check In Date *

Check In Times *

Check Out Date *

Check Out Times *

*All checkouts should be completed before noon, unless other times have been approved

Do you have any early arrivals? (include Staff)

Yes

No

What is the total number of early arrivals, including staff?

Dates and times of early arrivals

Do you have any early departures? (Include Staff)

Yes

No

How many early departures, including staff?

Dates and times of early departures

Total Number in group (including early arrivals) *

Number of Males *

Number of Females *

Number of Chaperones/Counselors *

How many High School Students (13-18)? *

How many College Aged Students? *

How many adults? *

***UTC Housing requires 1 Adult for every 25 students age 13-18; Children under the age of 13 are not permitted to stay in on-campus housing. Group coordinators, are responsible for conducting background checks for all camp employees working with minors, in compliance with Tennessee law.

Will your participants be arriving as individuals or school groups?

Individuals

School Groups

Do you have a specific request for check-in location (either at your preferred complex or elsewhere on campus?)

Apartment Request - Top Preference

Apartment Request - 2nd Preference

Apartment Request - 3rd Preference

Community Room Request $25 per day

If you are staying in a building with card swipe access (Stagmaier, Walker, UC Foundation or Decosimo), will your group need temporary swipe cards issued?

If yes, how many?

How will you be paying for the bill?

Transfer Voucher

Invoice

Special needs (Alternate billing contact, other space requests, etc)

Housing and Residence Life

UTC Housing and Residence Life

Summer Camps and Conference Housing

Request for Space