University Chapel & Museum Reservation Form (Sponsored Group Use)

Date Reservation Requested: *

Fee Amount: *

Date Fee Submitted: *

$75 Security Fee Submitted?: *

Certificate of Insurance? (Contact Treasurer's Office: 540-458-8121): *

Name or Type of Event: *

Date of Event: *

Time of Event: *

Time Seating to Begin: *

*For groups of over 250, please allow 45 minutes for seating.

Time Chapel will Be Vacated: *

Speaker (if applicable):

Date & Time for sound check with Speaker, if applicable (please allow 30 mins):

Estimated Audience Size (Capacity 500): *

Does the event require tickets? *

YesNo

Ticket Information:

W&L Co-Sponsor: *

W&L Co-Sponsor Department: *

*A contact of the organization, who will assume full responsibility for the group's event, must be present at all times during the event. This individual is responsible for leaving the premises in good condition and is responsible for cleaning up any outside supplies brought to the Auditorium.

Contact Person: *

Contact Address: *

Contact Phone: *

Contact Email: *

Event set-up options are available in the chapel. Please select your preferences.

Podium: *

Podium center front of stage
Podium stage left
Podium stage right
No podium (podium microphone not available)

Microphones: *

Lavalier
Podium mic
Hand-held mics
Table-top mics

Lighting: *

Daily Setting: Lights full on in statue chamber, stage lights on with the exception of center lights, auditorium lights on.
Special Setting: Lights off in statue chamber, stage lights off, auditorium lights off with the exception of the balcony.
Event Setting: Lights very low in statue chamber, stage lights on, auditorium lights on. (NOTE: The Event Setting will be used when fire doors are closed.)

Statue Chamber: *

Fire doors closed, flags in front
Grill gates only, flags in front
Grill gates only, no flags

*The University Chapel can provide up to 11 chairs for the stage. The number of chairs and microphones needed should be indicated below in the Special Requests, Instructions, or Additional Information.

*The scheduling department/organization is responsible for providing bottled water for the speaker.

Special Requests, Instructions, or Additional Information: