Facility Request

Please answer and fill in ALL areas of the contract. Not doing so may cause a delay in the processing of your paperwork.

A. Sponsoring Organization:
Profit     Non-Profit [501C3# ]     Government     Public School
Sponsor's Contact Person:
Address:    City:    State:    Zip:
Day Time Phone:    FAX:    E-mail:
B. Specific Name or Descriptive Title of Event:
Approximate number of people expected to attend:
C. Purpose of facility usage:   Business/Organization Mtg. Product Sales   Training Mtg.   Conference
D. Briefly DESCRIBE meeting: (Who is the intended audience AND what is the purpose of the meeting?
E. Arrival time: Exit time:
(Events may begin as early as 7:00 a.m. and end no later than 10:00 p.m.)
Date(s) of Event Starting
Room(s) Assigned
Day Month Date Year

Facility Requested: (Please check your choice(s)):
      Conference Room       Classroom       Performance Hall **       Little Theatre **

Conference Room Setup Style Requested:
Classroom style   Theater style (chairs only)   Banquet style (chairs on both sides of tables)
Boardroom style   Horseshoe style   Square style   Round Table style   Other: Attach drawing
Serving Table(s); How many?        Display Table(s); How many?
Head Table(s); How many? , How many chairs?
How many rooms are needed?
Other Setup Requirements:

**Performance Hall or Little Theatre Setup Requirements: Fill out a Tech Checklist Form

G. Equipment Requested for Conference Rooms and Classrooms:
NONE Flipchart Paper (additional charge-$10.50/pad) Laptop W/CD
Podium ONLY Flipchart Holder ONLY TV/VCR or  DVD US Flag
Podium w/Microphone Whiteboard Screen NM Flag
Microphone Display Easel LCD Projector Extension Cord(s)
Lavalier (Lapel) Mic Overhead Proj. (for transparencies) Other
H. 1. Will admission or participant fee be charged? Yes No
2. Ticket Prices:      Child $       Student $       Adult $       Senior Citizen $
Discounts $
3. Will reservations be taken? Yes No
4. Will tickets be sold at the door? Yes No
5. Where and when can tickets be purchased other than at the door?
6. Will donations be accepted? Yes No
7. Will food/beverages be sold? Yes No
If "yes", please explain:
9. Will merchandise be sold? Yes No
If "yes", please explain:
11. Will booth space or table space charges be assessed? Yes No
If "yes", please explain:
*13. Catering requested:    (Call 566-3155 for catering list) Yes No
*14. Extra security requested? Yes No
*15. Audio-visual helper requested? Yes No
  *Answering "yes" to #13, #14, and #15 may require sponsor to pay additional fees.

This agreement is between San Juan College, 4601 College Boulevard, Farmington, New Mexico 87402 ("COLLEGE")
and                                                                                                                                                                  ("SPONSOR")
With an address of                                                                       ,                                                   ,                                
SPONSOR Contact Person:                                                                        Phone Number:                                         

  1. All user groups, organizations and individuals must follow State of New Mexico laws and San Juan College policies, rules and regulations.
  2. SPONSOR assumes full responsibility for all facilities and equipment damage, etc., and agrees to promptly reimburse the COLLEGE for any damages.
  3. SPONSOR hereby agrees to forever release and discharges the COLLEGE, its employees, representatives and agents from any liability of any nature whatsoever, incurred by virtue of the use of the COLLEGE property. SPONSOR expressly waives and relinquishes any and all rights under the law or statute to the contrary. SPONSOR further agrees to indemnify and hold the COLLEGE harmless from any liability, actions, causes of action, claims, demands, damages, costs, fees, loss of services, expenses, costs of services, cost of defense, attorney fees, compensation, and any other expenses of any nature whatsoever, whether direct or consequential, arising out of the use of the COLLEGE property, irrespective of whom the claimant is.
  4. SPONSOR will be on the premises at all times during the scheduled event, including prior to and following the event.
  5. The SPONSOR will not sublet these facilities or equipment or assign the reservation lease covered by this Agreement, whether for cash or in-kind consideration, without the prior written consent of the COLLEGE.
  6. Audience capacity may not go beyond state fire codes. Any violation of such may be grounds for cancellation.
  7. SPONSOR agrees to maintain crowd control.
  8. Smoking is prohibited indoors, and within 50 feet of the buildings.
  9. No food or beverages are permitted in carpeted lobbies, gymnasium or on stage in theaters (unless called for in theatrical scene). No alcoholic beverages are allowed. If food is needed for your event please contact catering services at 505-566-3155. (This does not apply to potlucks provided by the SPONSOR and APPROVED by the COLLEGE).
  10. Facility or equipment usage fees (if any) must be paid prior to the event.
  11. Agreement and all necessary attachments, completed and signed, must be in the Office for Learning at least one week before the event date (with full payment). Not accomplishing this may be grounds for cancellation of facility and/or grounds usage.
  12. When on campus, keep a copy of this Agreement on hand at all times.
  13. IN CASE OF EMERGENCY WHILE ON CAMPUS: Notify Safety and Security Office (dial 566-3333 or 3333 on a campus phone).
  14. I have read and agree to the preceding terms and conditions:
    X Signature of SPONSOR      X Date
    COLLEGE approved: ___________________________________________ Date: _______________________
This form is only an application. Reservations are official ONLY when the approved copy of this Agreement and all the relevant attachments are returned to the SPONSOR.

     Fees to be paid: $__________          By: ____________________         Total Due: $__________

Please return this form to: SAN JUAN COLLEGE/Office for Learning; ATTN: Alana Vanden Broeck; 4601 College Blvd.; Farmington, NM 87402 OR Fax to: (505) 566-3192

OFFICE USE ONLY: Res.#: _____________________________________

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