Please fill out this form at least two full weeks before your event or activity takes place. All activities must be consistent with University rules, policies, and procedures, as well as the mission and purpose of your organization. If you have any questions, please contact the Assistant Dean of Students at 780-4942 or via email at oconnorc@usm.maine.edu.

Contact Information:
Organization's Name:
Submission Date:
Individual Coordinating Event:
Coordinator's Title:
Coodinator's Email:
Organization Advisor:
Advisor's Email:

Event Information:
Title of Event/Activity:
Date of Event:
Time of Event:
Location of Event:
Number of Attendees:

Please Briefly describe your event:


Event Checklist:
Please indicate whether your event involves the following:
Physical Activity
Travel to an off-campus location
A contract with a non-University entity
Audio-video equipment
An ourdoor location that can be affected by weather
Assistance with parking/transportation
Alcohol
Room set up of tables, chairs, etc.
The sale of items on campus

You will be contacted a few days after completing and sending this form.