Event Name
Event Coordinator(s)
Email
Requested Event Dates (1-3 Order of Preference)
Type of Event and Brief Description
Event Start Time - Event End Time
Set up time needed:
Equipment Needed
Attendance Expected
Would you like to open this event up to the rest of the Queen’s Community? YesNo
Will you need us to book a DJ for the event? ($100 additional charge) YesNo
Would you like us to provide coat check staff for this event ($150 additional charge)? YesNo
Will you be bringing food? YesNo
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Club Name
Phone Number
Number of Line-skip Tickets (Maximum of 50) for the Night?