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Facility User Intake

Proposed User Name *
Proposed User Address *
Proposed User Email Address *
Proposed User Phone Number
Federal Employer ID Number *
Is the User Tax Exempt? *
If tax exempt, specify
Purpose of Use
Date and Time of Proposed Use
Duration of Use
Area of Campus for Proposed Use
Services requested of CBU by User (e.g. food, audio visual, etc. )
One-Time or Repeat Use (select one) *
If Repeat Usage, is a Lease or Other Occupancy Agreement Required or Being Requested By the Proposed User?
Is the Proposed Use Sponsored By, or Endorsed By CBU? *
If Yes, specify
Does the Proposed Use Benefit CBU Employees, Students, or Alumni? *
If Yes, specify
Will the Proposed Use Be For An Event That Is Open To the Public? *
If Yes, specify
Will the Proposed Use Generate Revenue for a Third Party? *
If Yes, specify
Proposed User’s Relationship to CBU
If you chose Friend/Relative or other, please specify
Name of Event *
Number of Attendees