Facility Rental Request Form Facility Rental Request Form A two week minimum advance notice on all rental requests is required. A Certificate of Insurance is required for non-UIC groups. Questions can be emailed to: Jessica Adkisson *All Questions Requires Response Date of Request:Please enter up to three dates or date ranges ranking with the most preferred date or range in the first box, Choice A.1. Choice A [Most Preferred Date(s)]: - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY 2. Choice B: - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY 3. Choice C: - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY 4. Time range * Required5. Event Activity * RequiredSelectClimbing Wall PartyPool PartyOther Facilities Requested6. Sports and Fitness Center (West Side) * Required Fitness Room Gym Multipurpose Room Basketball Courts Racquetball Courts Pool None 7. Student Recreation Facility (East Side) * Required MAC Gym Meeting Room Multi-Purpose Room Basketball Court A Basketball Court B Basketball Court C Basketball Court D Raqcuetball Court 1 Raqcuetball Court 2 Raqcuetball Court 3 Raqcuetball Court 4 Raqcuetball Court 5 Basketball Courts (Outdoor) Pool Lobby Second Floor Lounge Running Track Tennis Courts (Outdoor) Climbing Wall None Outdoor Recreation8. Fields * Required East Field West Field None 9. Sand Volleyball * Required North Middle South None Organization10. Name * Required11. For Business Type: * RequiredSelectCorporationGovernment Entity - FederalGovernment - LocalGovernment Entity - StateIndividualLimited Liability CompanyNot for Profit CorporationPartnershipSole ProprietorshipUIC Student Organization12. Representative/ Primary Contact * Required13. Contact Person's Title: * Required14. Contact Phone * Required15. Contact Email * Required 16. Affiliation * RequiredSelectStudentFaculty/StaffMemberCommunity17. UIC Department/Office: Mailing Address18. Street * Required19. City * Required20. State * Required21. Zip * Required Event22. Event Description: * Required23. This event is:SelectFor UIC Students OnlyOpen to everyoneFor your Organization only24. Expected number of participants? * Required25. Expected number of spectators? * Required26. Expected number of UIC members? * Required27. Expected number of Non-members? * Required28. Are minors involved? * RequiredSelectYesNo29. Will there be any food or drink served? * RequiredSelectYesNo30. If yes, please provide details on what will be served: * Required Miscellaneous31. Special Notes * RequiredIf requesting courts, please note how many.32. Please list all equipment (tables, chairs, trash cans, audio, visual, etc.) you are requesting and any special set up needs: * Required This iframe contains the logic required to handle Ajax powered Gravity Forms.