University Center Application for Use of Facilities

Responsible Contact Information

Contact Name *

Contact Email *

Contact Phone *

Company/Organization Name *

Company/Organization Street Address *

Event Information

Event Title *

Event Description *

If you selected the Chattanooga Room, which section(s) will you need?

Chattanooga A

Chattanooga B

Chattanooga C

Chattanooga AB

Chattanooga BC

Chattanooga ABC

The Chattanooga Room has 3 sections (A, B, & C) with Chattanooga C having the windows.

Day(s) and Date(s) Requested *

Actual Event Start Time (Please Specify AM/PM) *

Actual Event End Time (Please Specify AM/PM) *

Do you need any reserved time before the event for your set-up? *

None

15 Minutes

30 Minutes

45 Minutes

60 Minutes

More Than 60 Minutes

Do you need any reserved time after the event for your breakdown? *

None

15 Minutes

30 Minutes

45 Minutes

60 Minutes

More Than 60 Minutes

Estimated Attendance *

Who is your target audience? *

UTC Faculty, Staff, and Students

UTC Alumni

Non-UTC Community Members

Attendees will include: *

UTC Faculty, Staff, & Students

UTC Alumni

Specific Invited Public Guests (Not General Public)

Open to General Public

If your event will have specific invited public guests or will be open to the general public, how many non-UTC community members are you expecting?

Will your event bring anyone under the age of 18 years old on campus? *

Yes. They will be accompanied by a parent/guardian.

Yes. They will be in a group accompanied by a teacher/counselor.

Yes. They will be dropped off and event staff will be responsible for them.

Will money be exchanged for this event? *

Yes - Tickets will be pre-sold only and there will be NO ticket or merchandise sales on site.

Yes - There will be will admission and/or merchandise sales on site.

Yes - There will be book sales on site. (Must Coordinate Through Campus Bookstore)

On site money exchanges (ticket, merchandise, book sales, etc.) may require UTC Police to be present for your event.

If your answer to the previous question was Co-Sponsored, Speaker or Lecture, or Other, please provide additional information. (Name of speaker, topic of event, co-sponsoring organization, etc.)

Requested University Services

Food and/or Beverages Served? *

Yes - Refreshments

Yes - Buffet Meal

Yes - Plated Meal

Yes - Boxed Lunch

All food in the University Center must be catered through Mocs Catering. You can contact Mocs Catering at 423-425-4200. To avoid late fees, orders should be finalized at least 7 days prior to your event. *

I understand I must use Mocs Catering for my food and beverage needs.

If you have requested either the Tennessee or Chattanooga Rooms, what type(s) of set-up will you need?

Auditorium (Rows of Chairs)

Banquet

Crescent (Round Tables with No Backs to Front of Room)

Classroom (Rows of Tables & Chairs)

Fair/Expo

Reception

Empty Room

Other (Please provide a set-up description in the Additional Information box below)

What audio/visual needs are there for your event? *

None

Computer, Screen, & Projector

Microphone (Please see next question)

If microphone(s) are needed, please indicate how many and what type. (Number, wireless or wired, lapel, etc)

You must contact the UC Office at 423-425-4455 regarding specific set-up details at least one week prior to your event.

I Understand

Would you like to have a Media Tech staff your event? *

No, I do not need a Media Tech for my event.

Yes, I would like a Media Tech to staff a portion of my event. (See next question)

Yes, I would like a Media Tech to staff the duration of my event.

A Media Tech is a staff member who will work your event for the purpose of assisting with audio/visual needs (not including recording and streaming.) The cost for a Media Tech is $15.00/hr with a 2-hour minimum on weekdays and a 2-hour minimum on weekends. If you need a Media Tech for the duration of your event or only for the beginning of your event, they will be scheduled to staff your event at least 30 minutes before your Event Start Time.

If you only need a Media Tech to staff a portion of your event, please provide the following time(s) here.

Additional Information

Please provide any additional information or special requests for your event below.

Facilities Use Terms and Conditions - Safety and Risk Management Statement

In consideration for the permission of the University of Tennessee at Chattanooga to allow use of premises, the undersigned agrees to assume all responsibility and legal liability arising out and in the use of the aforementioned property. The undersigned further agrees to indemnify, save and hold harmless, the University of Tennessee at Chattanooga and its employees from any liability arising out of the use of this property. Further, the undersigned agrees to abide by all rules, standards or reasonable requests made by the University of Tennessee at Chattanooga relating to the use of the these facilities and to adhere to all safety/fire code/minors on campus requirements as set forth by the University and to instruct participants to adhere to the same. Depending on the type of liability exposure, I understand that I may be asked to provide proof of current liability insurance and a certificate of insurance evidencing the University of Tennessee at Chattanooga as listed additional insured. *

I understand and accept the safety and risk management statement.

Facilities Use Terms and Conditions - Equal Opportunity Statement

The University of Tennessee at Chattanooga is an equal employment/opportunity/affirmative action/Title VI/Title IX/Section 504/ADA/ADEA institution. *

I understand and accept the Equal Opportunity Statement.

Facilities Use Terms and Conditions - Electronic Signature

I have read and understand this agreement, and I am aware of the Facilities Use Terms and Conditions above. I acknowledge that all listed information is accurate, and I will let the appropriate department know if anything changes before this event. I understand that failure to meet any conditions of this agreement shall result in a cancellation at any time. I understand that this form is an application, and this event should not be promoted until confirmation is received. I will also be responsible for any billing services incurred. By electronically signing below, I am signifying that I have read and understand this agreement. *

University Center

University Center

Application for Use of Facilities

Note: This form is for non-UTC entities and private individuals. UTC Departments and Student Organizations should go use the Department and Student Organization Request.

Prior to completing this form, please visit our "Rooms" page for room descriptions and pictures to ensure your requested rooms will meet your meeting or event needs.

Also, please look over the our "Renting Space" section for fee information.