Lubin House Event Booking Request

Contact Information
Name (Required) Name (Required) First Last
Email (Required)
SU ID Number (Required)

SU ID cards are required for Lubin House access during your stay
SU Department (Required)
Contact Person Email

Enter an email address for the point of contact, if different from the guest.
Phone Phone - ### - ### ####
Full Time Permanent Employee

Full Time Permanent Employee Yes No
Event Information
Name of Event/Program (Required)
Event Date (Required) Event Date (Required) / MM / DD YYYY
Event Start Time (Required) Event Start Time (Required) : HH MM AM/PM
Event End Time (Required) Event End Time (Required) : HH MM AM/PM
Desired Room(s)

Desired Room(s) Pergament Room 1870 Room Library Talent Room Classroom Small Conference Room Other Other
Desired Room Setup
Number of Attendees
Catering Needs

Catering Needs Breakfast Lunch Dinner Sweets Tray Stationary Hors d’oeuvres Passed Hors d’oeuvres Other Other
Beverage Needs

Beverage Needs Bottled Water Soft Drinks Juice Coffee/Tea Pellegrino Beer Wine Prosecco Mixed Drinks Other Other
Miscellaneous Needs

Miscellaneous Needs Projector and screen Laptop Conference phone Easel and flip pad Microphones Other Other
Additional Notes
Billing Information
Chartstring (Required)

Format: xx-xxxxx-xxxxx-xxxxxx(-xxxxxx)
Online Journal Entry Approver (Required) Online Journal Entry Approver (Required) First Last
Approver Email (Required)