NEW SMC Preliminary Community
Facility Request

THIS IS JUST A PRELIMINARY FORM. AT THE POINT OF SUBMISSION OF THIS FORM, FACILITIES HAVE NOT BEEN RESERVED FOR YOUR EVENT. Once your request has been reviewed and a room assignment can be confirmed, you will be notified of the finalized details of your reservation via the email address you provide below.

BEFORE RESERVING, PLEASE READ THE Facility Use Policy.

Please put your initials here to indicate that you have read the Facility Use Policy and that you are responsible for this reservation. *

Contact Information

Organization *

Occassionally, we encounter emergencies (such as inclement weather or power outages) and we have to notify the person in charge of the event that the event is cancelled or delayed. Please enter the name of the person who will be on campus running the event. Please enter their name and cell phone number below so that we can contact them while they are on campus at the event.

Contact Person *

Cell Phone *

Title *

Email address *

Street *

City *

State *

Zip Code *

EVENT DETAILS

Name of Event *

Number of Participants *

EVENT TIMELINE

When scheduling your event, please adjust your start and end times to allow time before your event for setup and after the event concludes for cleanup if needed.

If you do not include setup and cleanup times in the timeline for your event, you can expect that the room(s) you reserve will only be accessible approximately 10 minutes prior to Start Time indicated below and will close at the End Time indicated for your event.

Reservations will not be accepted more than 6 months in advance of an event.

Event Frequency *

One-Time Event

Multiple Dates

Recurring

Actual Event

If no setup/cleanup time is selected, access to the venue will begin at the time you state below in the BEGIN TIME EVENT and you will be expected to leave at the END TIME EVENT stated below.

Any additional time you require must be stated in SETUP and CLEANUP below.

Do you need time to set up or time to clean up? * *

None

Setup

Cleanup

Start Date Of Event * +

End Date Of Event * +

Begin Time of Event *

End Time of Event *

Week Day of Actual Event *

Do you have additional dates for this event? *

Yes

No

Please list your additional dates: *

Additional Information on Event Scheduling - please include any other details pertaining to the scheduling of your event as needed.

Setup Info

Start Date of Setup. * +

End Date of Setup. * +

Begin Time of Setup *

Week Day of Setup Event *

End Time of Setup *

Cleanup Info

Start Date of Cleanup . * +

End Date of Cleanup * +

Begin Time of Cleanup *

Week Day of Cleanup Event *

End Time of Cleanup *

Preferred Event Location

Campus *

Dowagiac Campus

Niles Campus

Do you know what building you would like? *

Room number

Description of what kind of room you need: *

Please describe what alternative arrangements you have made for your event in the event of inclement weather or please tell us if your event will be cancelled in the event of inclement weather. *

Electronic Equipment Requirements

Do you require any audio, visual or computer equipment for your event? *

Please check off any audio, visual or computer equipment you will need for your event. *

Blue-ray/DVD Player

Mounted Projector (Full size HDMI ports available for personal devices)

Sound System (Sound output from projector or amplified speakers in some rooms)

Presentation Computer (Windows 10 Only)

Laser pointer clicker

General Classroom AV (Windows 10 Computer, Projector, BluRay/DVD Player and Sound capability)

Video Recording (dependent on room choice)

None Needed

Room Layout Instructions

If you have any special instructions for the room layout, please enter them in the box below. If you have a room drawing, please email it to events@swmich.edu.

Liability Insurance

Southwestern Michigan College requires that any organization who uses our facilities have liability insurance in effect during the time frame of this event. SMC must receive proof of this insurance coverage prior to your event.

Please provide Liability Insurance via one of the following methods prior to your event:

U.S. Mail: Send a copy of your proof of insurance to Southwestern Michigan College, Buildings and Grounds Department, 58900 Cherry Grove Road, Dowagiac, Michigan 49047;
Facsimile: Send your proof of insurance via facsimile to the Maintenance Department at Southwestern Michigan College at 269-782-1394; or
Email: Email proof of insurance to the Administrative Assistant for Buildings and Grounds at Southwestern Michigan College at events@swmich.edu.
Upload it below.

Upload your proof of Liability Insurance information here:

General Comments - please enter any additional questions.

Use of Facilities Policy Acknowledgement

The submitter of this form (who is 18 years of age or older) acknowledges or organization agrees to be responsible for the use of the premises, including the actions of those in attendance at the event. The submitter and/or the organization agree to indemnify and hold harmless Southwestern Michigan College, its officers, agents and employees against all claims, demands or causes of action against them for property damage and/or personal injury arising out of the use of the College facilities by the undersigned even if such claims, damages or causes of action allege negligence or other fault on the part of the College, its officers, agents or employees. Further, the submitter agrees to indemnify the College for any damage to College property arising out of the use of the College facilities by the submitter or organization.

Acknowledgement Signature *

clear

Date of form submission * +

Monday	Tuesday	Wednesday	Thursday
Friday	Saturday	Sunday

Monday	Tuesday	Wednesday	Thursday
Friday	Saturday	Sunday

Monday	Tuesday	Wednesday	Thursday
Friday	Saturday	Sunday

NEW SMC Preliminary Community Facility Request