Facilities Use Form This form should be turned in no less than two (2) weeks before the scheduled event. Submission of this form does not constitute a reservationand does not guarantee service or staffing availability. Availability of rooms, equipment and staffing will be determined by Business Services and IMS. Event Title: Event Date: Space should be setup by: -- 1 2 3 4 5 6 7 8 9 10 11 12 -- 00 15 30 45 AM PM Event Start Time: -- 1 2 3 4 5 6 7 8 9 10 11 12 -- 00 15 30 45 AM PM Event End Time: -- 1 2 3 4 5 6 7 8 9 10 11 12 -- 00 15 30 45 AM PM Event End Date (if applicable): Publish on Web Calendar: Yes No Host Department/Organization: Event Location/Building: Ad Building Centennial Plaza Fine Arts Center Franz Center Goering Hall Goerz House The Green Haury Hall James A. Will Family Academic Center Kauffman Museum Kidron Bethel Village KIPCOR Krehbiel Science Center Leisy House Mantz Library Memorial Grove Mem Hall Schultz Student Center Thresher Gym Thresher Stadium Voth Hall Wellness Center Room or Space: Attendees Expected: Contact Person: Phone: E-mail: Admission Fee or Suggested Donation: Yes No Audio Reinforcement (PA): Basic Installed system (User Operated) Basic Installed System (BCAV Tech Operated) BCAV Provided Portable System Video Display Installed Projector/Monitor (User Operated) Installed Projector/Monitor (BCAV Tech Operated) Additional BCAV Provided Equipment: Computer DVD/BluRay Camera AV Recording / Streaming (Additional Fee) Subject to BCAV technician availability. Includes recording file available from Bethel. Live Stream (includes recording) Stream scheduled with MarComm <marcomm@bethelks.edu> Stream scheduled with Music Department <musicdept@bethelks.edu> Video Recording (includes audio) Audio Only Recording Multi-Camera Stream/Recording Other tech requests (elaborate in the box below). These MUST be cleared through BC AV. Already cleared through BC AV <bcav@bethelks.edu> Support Equipment: Folding tables Number: , Size: Folding chairs Number: Extension cords Number: , Length: Display Easels Number: Piano (FAC, Mem. Hall, and SSC only) Kitchen Access (FAC only) Staffing requests Events staff IMS staff Custodial staff Lighting requests Mem Hall stage lights KA stage lights general wash Set lights beyond stage wash (coordinate with AV staff) Request for access to catwalks to set lights Thermal temperature stand Thermal temperature stand I acknowledge the machine will be monitored 15 minutes prior to and 15 minutes past the event start time. Bethel College Business Services and Information & Media Services reserve the right to modify your request according to availability and/or appropriateness. Some fees may apply based on space, services or equipment associated with the event. Form Version: v2024080600 Signature By signing below, I agree to abide by all Bethel College and campus regulations regarding the use of space and I agree to restore the space to an orderly condition for the next user. I also recognize that this is a request for space and equipment, not a confirmation and that I should not advertise this event until I have received a confirmation from Bethel College Business Services. I also agree to make a concerted effort to lock or in another manner secure the rooms and or buildings utilized in my event. If I am unable to lock the spaces, I will contact Bethel personnel to help with the securing of the spaces. Department or Organization Representative: PLEASE NOTE SPECIAL SETUPS or submit additional sheets to Business Services ← Back