University Affiliation:
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Name
*
First
Last
Address
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Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
United States
United Kingdom
Canada
Australia
Netherlands
France
Germany
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Afghanistan
Albania
Algeria
Andorra
Antigua and Barbuda
Argentina
Armenia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
Gabon
Gambia
Georgia
Ghana
Greece
Grenada
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Country
Telephone
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Fax
*
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Email
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Best time to contact
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:
HH
MM
AM
PM
AM/PM
Date Desired - 1st
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MM
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DD
YYYY
Date Desired - 2nd
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MM
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DD
YYYY
Date Desired - 3rd
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MM
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YYYY
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Full Ballroom
Center Ballroom
Blue 102
Gold 104
Aggie 101
Pride 103
Board Room
Alumni Conference Room
AFEC Conference Room
Library
Lobby price varies upon request and time
Estimated Attendance
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Event Time: Start:
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:
HH
MM
AM
PM
AM/PM
End:
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:
HH
MM
AM
PM
AM/PM
Event Description
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Event Purpose
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Publicity Mode
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(Publicity should be approved by the Alumni-Foundation Event Center. All students and student organizations are guided by
NC A&T State University policies. (Students contact the Office of Student Development))
Please check the seating arrangement you desire for your event
*
Exhibition
Gallery & workshop
Classroom
U Shape
Hallow
Theatre
Boardroom
Dinner Dance
Chevron
Royal
Cabaret
Canteen
T Shape
Banquet
Others Settings
Event Type
*
Food Tasting
Bachelor Party
Bachelorette party
Banquet
Family Reunion
Bridal Shower
Rehearsal
Rehearsal dinner
Fundraising
Networking
Wedding Ceremony
Pre-Reception
Reception
Workshop
Forum
Expo
Bachelorette Brunch
Seminar
Business Meeting
Trade Show
Exhibition
Conference
Other Event Type
Caterer
Name
First
Last
Phone
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Email
Rental Company
Name
First
Last
Phone
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Band (May require (Destro/ Electrical power distributor for a fee of $150.00)
*
Yes
No
Pre-reception
*
Yes
No
Event Center Lobby ($150.00 cleaning fee)
*
Yes
No
Center Pieces
Fresh flowers
Silk flowers
Table Cloths
Buffet
Plated
Pass hor 'oeuvre
Other Services
Cash bar
DJ
Band
Speakers
Event Planner/Coordinator
Alcohol will be Served
*
Yes
No
The following is required for events past 10pm and when alcohol is served:
Professional bar tenders/security officers a service fee will be charged accordingly.
(The person booking event will be responsible for the payment of the fees associated with these services)
Event Audio/Visual Resources
AV support fees apply to all multimedia presentations to include power point and Audio/Visual presentation. (Based upon request)
A/V Services Planning (Prices base on request)
PowerPoint Presentation (submit presentation to Event Center a minimum 5 business days prior to event)
Audio (CD player) (IPod) House PA System
Pre-Function Plasma Screens
Laptops
LCD Projector w/screens
Wired Microphone w/stand
Wireless Microphone w/stand or Wireless lavaliere
Power Distro is required by all band and extensive power outsourcing
DVD Player
Wireless Presenter
Conference Call (price available upon request)
Credit card outlet (Client must bring own credit card machine and cord)
Lighting packages (price available upon request)
Other Services
Set- up time preference:
*
1 hour prior to event start time (standard No Charge).
2 hour or more prior to the event charges apply-based upon availability
Need access to the event center for time other than the day of the event – charges may apply
Others
Police/Parking Services
*
Parking service requested (Recommended for major events during business hours 8.a.m. to 5.p.m.)
Event Center Resources ( See resources price list)
*
Stage w/skirting (8’X 6’) (per deck)
Registration Table (Pre-Function Area 8' table)
Cocktail Table
72" Round Table
8 foot square table
6 foot square table
Easel
Podium
Table top podium
Bar stool (Price available upon request)
Reservation procedure:
Event date requested are not reserved until the event center receives your payment, electronic copy of your purchase order number or procurement card with a signed quote/contracts are received.
Name
*
Signature
*
Date
*
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MM
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DD
YYYY
Additional Notes: