Rental Reservation Request Form | Northwest-Kansas City

Step 1: Client Information

*First Name:

*Last Name:

*Company/Organization:

*Email Address:

Step 2: Event Information

*Event Name:

Description:

*Approximate Number of Attendees:

*Will the event have minors? Yes
No

Number of Minors Attending:

*Event Date:

Event Time (time when attendees will arrive and depart)

*Start Time:
Event Start Hour: Event Start Minute: Event Start 12-Hour Display:

*End Time:
Event End Hour Event End Minute: Event End 12-Hour Display:

On-site Event Coordinator

The on-site coordinator is someone who will be present during the entirety of the event and will act as the event's main contact person.

*Full Name:

*Cell Phone Number:

Step 3: Event Specifications

Room Configuration

Need multiple room configurations? If so, please contact Northwest-Kansas City at nwkc@nwmissouri.edu.

*Room Layout:

If other, please describe how you would like the room configured for your event.

Equipment Needs

Equipment: Projector
Laptop
Presentation Remote
Presentation Audio/Sound
Microphone and Portable Speaker System
Wireless Mouse
External Computer Speakers (classrooms are already equipped with audio)
Conference Phone
Video Conferencing Equipment (conference camera and paddle microphones)
Easel
Power Strip(s)

Extension Cord(s)

Power Tower(s)

Are you bringing your own laptop to hook up to our projector? Yes No

What kind of connection does your laptop utilize? (i.e. VGA, HDMI, Display Port)

Catering

Northwest Missouri State University does not provide catering services. Please feel free to utilize an outside catering company for your event. Please note that it is your responsibility to arrange your catering and to make sure that all items necessary for consumption are included (i.e. plates, napkins, silverware, cups). The person that has been designated as the on-site coordinator should facilitate your event’s catering arrival and setup.

*Will this event be catered? Yes
No

Name of Catering Company:

Number of Tables Needed for Catering:

Note: If using the conference room, there is a credenza inside the room already that can be utilized as well.

Location of Tables:

Miscellaneous Information

*Do you need a registration table(s)? Yes
No

*Number of Registration Tables Requested:

*Registration Table(s) Location:

Meeting Title for Event Signage:

*Do you need a rolling coat rack? Yes
No

*Do you need a cocktail table(s)? Yes
No

Number of Cocktail Tables Requested:

To retain a copy of this application for your records,
PLEASE PRINT THIS PAGE NOW!

Northwest-Kansas City
6889 N. Oak Trafficway
Suite 400
Gladstone, MO 64118

855.445.7461
nwkc@nwmissouri.edu

Event Request Form

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