UCSF Faculty-Alumni House Rental Form

Name of Responsible Contact

Name of Sponsoring Group

Name of Event or Purpose of Event

Email Address

Alternative Email Address

Phone Number

Campus Mailbox (if a UCSF event host)

Requested Date of Reservation

Event Start Time

Event End Time

Setup Access Time

UCSF Speed Type/Cost Center

Number of Attendees

Additional Services

Please select any additional equipment you may need.

LCD Projector ($50 per day)

10 Line Phone-a-thon Phone Bank ($50 per day)

Polycom Speaker Phone ($50 per day)

Up to 4 Flipcharts ($5 per day, per chart)

AV Needs

Please select the equipment you’ll need – if any – available in the Faculty-Alumni House, noting the location it should be set up. We do not have onsite technical support available, but UCSF hosts can make arrangements with Classroom Services. Music will only be played through a phone or MP3 player. We recommend that you supply your own device with playlist.

Caterer Arrival Time

Please note that all caterers must be on the Faculty-Alumni House list of approved caterers or must provide proof of license and insurance at least 48 hours prior to event.

Will alcohol be served?

Yes

If you checked yes to this question, please complete the Alcohol Request Form.

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.