Maintenance/Custodial Setup Request Form

Requisitioner Requisitioner First Last
First and last name of the person making the request.
Email

Contact email for individual making the request
Phone Phone - ### - ### ####

Phone number of individual making the request.
Cost Center
Activity

One line description of the activity the setup is being requested for.
Location

Location of where the setup will take place.
Date activity starts Date activity starts / MM / DD YYYY
Date activity ends Date activity ends / MM / DD YYYY
Needed for these days (between the above dates):

Needed for these days (between the above dates): Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Time activity starts Time activity starts : HH MM AM/PM
Time activity ends Time activity ends : HH MM AM/PM
Time setup needs to be completed Time setup needs to be completed : HH MM AM/PM
Describe setup needed

(Submit sketch in triplicate, if appropriate. Diagrams of Casbah, College Center, and Gym available in Student Life)