50th Anniversary
Facility Rental Request Form
Please provide the following contact information
First Name City
Last Name State/province
Title Zip/postal Code
Organization Work phone
Street Address Home phone
Address (cont.) E-mail

Enter the date of  the activity

-- mm/dd/yy

Enter the time of the activity

What activity will you be engaging in?

Which room are you requesting to reserve?


Do you need any special equipment?

Yes No

If so please indicate what you need

** Must be a KVCC student activity (no outside events or programs) **