Student Academic Project Form Tel. (818) 677-3644 Fax (818) 677-4172 Hours: 8 a.m. – 5 p.m., Mon. – Fri. www.csun.edu/usu/reservations Oﬃce Use Only Received: Accepted By: Student Name: ____________________________________ Address: ____________________________________ ____________________________________ Day Tel. Number: ____________________________________ Email: ____________________________________ Professor Name: ___________________________________ Oﬃce Ext.: ___________________________________ Course Name: ___________________________________ Course Number: ___________________________________ Event Date: ______________________________________ Room Preference: ___________________________________ Start Time: ___________________ End Time: ___________________________ Capacity: _______________________ Please describe the intended use of USU facility: ______________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ Student’s Signature ____________________________________________________ Date: ______________________________________________ Professor’s Signature ____________________________________________________ Date: ______________________________________________ Space is subject to availability. Rooms must be used standard, or the student will be charged a setup fee. This reservation does not include any special arragements, such as audio-visual equipment, etc.

Student Academic Project Form€¦ · Title: Student Academic Project Form Author: USU Reservations and Event Services Created Date: 3/5/2015 1:12:18 PM

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Student Academic Project Form

Tel. (818) 677-3644 Fax (818) 677-4172Hours: 8 a.m. – 5 p.m., Mon. – Fri.www.csun.edu/usu/reservations

Office Use Only Received: Accepted By:

Student Name: ____________________________________

Address: ____________________________________

____________________________________

Day Tel. Number: ____________________________________

Email: ____________________________________

Professor Name: ___________________________________

Office Ext.: ___________________________________

Course Name: ___________________________________

Course Number: ___________________________________

Event Date: ______________________________________ Room Preference: ___________________________________

Start Time: ___________________ End Time: ___________________________ Capacity: _______________________

Please describe the intended use of USU facility: ______________________________________________________________

___________________________________________________________________________________________________________

Student’s Signature

____________________________________________________

Date: ______________________________________________

Professor’s Signature

____________________________________________________

Date: ______________________________________________

Space is subject to availability. Rooms must be used standard, or the student will be charged a setup fee. This reservation does not include any special arragements, such as audio-visual equipment, etc.