Reservation Request Form
Please fill out form completely.

Organization or Department Name:
Is this event co-sponsored:	yes no
If yes, what organization(s) are co-sponsoring:

University Sponsored Organizations must complete the following:

	Organization is a non-profit organization eligible for exemption from real estate taxes under Section 420-a of the Real Property Tax Law of the State of New York.
	Organization can provide the University with a copy of the letter from the Internal Revenue Service stating that the organization is exempt from Federal income taxation under Section 501 of the Internal Revenue Code.
	Organization has comprehensive general liability insurance with a combined personal injury (including death) and property damage limit of at least $1,000,000 per occurance. The policy also includes contractual liability insurance coverage and New York University be named as an additional insured under the policy.

If you are able to comply with the above requirements, you are eligible to request space in the Kimmel Center.

Contact Person (name / title):
Telephone:
Fax:
Email:
Mailing Address:
Chartfield (University Departments):
ASSBAC Charge (All Square Clubs):
Organization Check:

Event Title:
Event Date(s):
Event Times:	Start Time: 1 2 3 4 5 6 7 8 9 10 11 12 : 00 05 10 15 20 25 30 35 40 45 50 55 am pm End Time: 1 2 3 4 5 6 7 8 9 10 11 12 : 00 05 10 15 20 25 30 35 40 45 50 55 am pm

Description of Event:

Anticipated Attendance:

NYU:    Non-NYU:

This is contingent on the specific room requested.

Row seating with head table
Row seating without head table
Conference set: square U shape
Banquet with round tables set for: 8 10
Cabaret with card tables set for 4
Reception with chairs around the perimeter of room
Open space
Other:

The Kimmel Center for University Life is a catered facility. All departments and University sponsored organizations are required to use Catering for all catering needs.

Is this event a catered event:

yes no

All alcoholic beverages must be catered and served through Catering and all State and NYU regulations must be strictly followed.

Will alcoholic beverages be served:	yes no
Will there be guests under 21 years of age present:	yes no

If yes, monitors may be required at the organizers' expense.

Are there any special security needs or concerns of which you are aware:	yes no
If yes, please elaborate:

By submitting the Kimmel Center online room request, I acknowledge that I have read, understand and agree to the Kimmel Center Policies and Procedures.