Personal Information:

Your Affiliation: Student
Faculty/Staff
External Organization/Individual

First Name: Last Name: Phone: Email:

Student ID:

School Affiliation: Select Your Location University CAS LAW SBS

Representatives of officially recognized student groups in the College of Arts and Sciences and the Sawyer Business School, as well as students, who are unaffiliated with a co-curricular organization sponsored by SBS or CAS, must contact Student Leadership & Involvement as sli@suffolk.edu or 617-573-8320 to reserve a space on campus.

Event Details:

Name of Event: Sponsoring Organization/Committee/Department Name: Date of Event:

Start Time 1 2 3 4 5 6 7 8 9 10 11 12 : 00 05 10 15 20 25 30 35 40 45 50 55 AM PM

End Time 1 2 3 4 5 6 7 8 9 10 11 12 : 00 05 10 15 20 25 30 35 40 45 50 55 AM PM

Are there any additional dates or times associated with your request (such as a recurring meeting)?

Please describe here:

Are you flexible with your date or time?

Please describe here:

Event Type Type of Event Review Session Guest Speaker Meeting Panel Reception Banquet Performance Video Conference Other Building: Select Building Stahl Center (73 Tremont) Sargent Hall (120 Tremont) Sawyer 20 Somerset First Choice/Preferred Room: Second Choice/Preferred Room:

Are you serving food? Yes No

Please Note: Food is not allowed in Sargent Hall Classrooms, Sargent Hall Courtrooms, and the Somerset Collaborative Learning Classrooms (114, 214, 314).

Are you serving alcohol? Yes No

Number Expected: Briefly describe the event. Please include any special requests, extended setup time needs, etc:

Organization Information:

Please provide the name and address of the sponsoring organization:

The sponsoring organization is a: Select 501(c)3 For-Profit (e.g. corporation, partnership) Federal Tax Exempt other than a 501(c)3 (e.g. trade association) Federal Government Agency Individual engaged in a business activity Other

Please explain:

Date of Event:

Start Time 1 2 3 4 5 6 7 8 9 10 11 12 : 00 05 10 15 20 25 30 35 40 45 50 55 AM PM

End Time 1 2 3 4 5 6 7 8 9 10 11 12 : 00 05 10 15 20 25 30 35 40 45 50 55 AM PM

Are there any additional dates or times associated with your request (such as a recurring meeting)?

Please describe here:

Are you flexible with your date or time?

Please describe here:

Approximate number of attendees: Program Title:

Building Requested: Select Building Stahl Center (73 Tremont) Sargent Hall (120 Tremont) Sawyer 20 Somerset

Please describe your space needs:

Program information:

Is this a joint program between Suffolk University and the host? Yes No

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Is the program sponsored by another college or university that plays a significant role in the teaching, programmatic, or evaluation function of the program? Yes No

Please identify the other college or university and the ways that it is involved in the program:

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Is Suffolk University involved in the development and/or delivery of the program? Yes No

Will SU professors teach or otherwise participate in any sessions of the program? Yes No

Please identify the Suffolk individuals and how they are involved:

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Please describe the program and the educational elements, including any ways that the program will enhance or improve the general skills and/or knowledge of the participants:

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Does the program involve political activities on behalf of a particular candidate(s) for office? Yes No

Please Describe:

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Who is the intended audience for the program? (e.g. students, general public, attorneys, etc.)

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Are Suffolk University students invited to participate in or attend the program and do you reasonably expect that they will? Yes No

Will they be charged to attend the program? Yes No

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Is the program conducted by an instructor with an educational background in the subject area? Yes No

Please Explain: