Conferences

Application for Conference Services

Please complete the form below. An asterisk (*) indicates a required field.

Organization Information

*Legal Name of Organization:

*Mission/nature of Organization:

*Organization's Mailing Address:

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Contact Information

*Primary Contact:

*Day Phone:

Cell:

*Email:

Secondary Contact:

Day Phone:

Cell:

Email:

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Tax Information

*Tax Status:

*Is this organization DC tax exempt?:

yes

no

DC Tax Exemption number (only if org. is DC tax exempt):

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Conference Information

*Conference Will Begin:	month ---------- January February March April May June July August September October November December	day --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31	year ------- 2011 2012 2013 2014 2015
*Conference Will End:	month ---------- January February March April May June July August September October November December	day --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31	year ------- 2011 2012 2013 2014 2015

*Event Start Time:	hours ---------- 01 02 03 04 05 06 07 08 09 10 11 12	minutes --- 00 15 30 45	am/pm ------- AM PM
*Event Start Time:	hours ---------- 01 02 03 04 05 06 07 08 09 10 11 12	minutes --- 00 15 30 45	am/pm ------- AM PM

Is this conference co-sponsored by an on-campus organization?:

Yes

No

*Total Number of Participants

*Total Number of Commuters

Total Number of Residents

*Purpose of Visit

How did you hear about conference services at CUA?:

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Meeting Facilities

*Please describe the meeting facilities your conference will require. Be sure to include the type(s) of room(s)/facility(ies), the date(s) & time(s) each room/facility will be used, and the number of people each room/facility must accommodate. Feel free to include any additional comments.

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Other Equipment & Audio-Visual Requirements

Please describe the AV and other equipment your conference will require. Be sure to include the type(s) of equipment and the date(s) & time(s) each piece of equipment will be needed. Feel free to include any additional comments.

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Housing Accommodations

(Available during summer months only. Inquire for available dates.)

*Will your conference require housing accommodations?:

Yes

No

If you answer "yes," the below fields marked with a blue asterisk (*) are required.

Please rank your residence hall preference... (1 = first choice, 3 = least favorite)

Air Conditioned Traditional Residence Hall:	1	2	3
Air Conditioned Suite-Style Residence Hall:	1	2	3
Air Conditioned Apartment-Style Residence Hall:	1	2	3

*Will you need linens included with the rooms?:

Yes

No

Number of Persons in Single Occupancy Rooms

Number of Persons in Double Occupancy Rooms

Organization is responsible for providing chaperones for minors staying in residence halls.

*Date of Arrival:	month ---------- January February March April May June July August September October November December	day --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31	year ------- 2012 2013 2014 2015
*Date of Departure:	month ---------- January February March April May June July August September October November December	day --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31	year ------- 2012 2013 2014 2015

Please Note: check-in is at 2:00pm on the date of arrival, check-out is at 10:00am on the date of departure.

Special Requirements

(i.e. single-gender residence halls, disabled accessibility, etc.):

Will your conference require dining services?:

Yes

No

If you answer "yes," the below fields marked with a blue asterisk (*) are required.

Date of First Meal:	month ---------- January February March April May June July August September October November December	day --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31	year ------- 2012 2013 2014 2015
Date of Last Meal:	month ---------- January February March April May June July August September October November December	day --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31	year ------- 2012 2013 2014 2015