Organization
Legal Name of Organization
*
Mission/Nature of Organization
*
Organization's Mailing Address
*
Primary Contact Person
*
Primary Contact Person Cell Phone
*
Primary Contact Person Email Address
*
Maryland Tax Exemption Status
Yes (must provide proof)
No
Program Information
First Day of Program
Program Start Time
12
1
2
3
4
5
6
7
8
9
10
11
:
00
30
AM
PM
Last Day of Program
Program End Time
12
1
2
3
4
5
6
7
8
9
10
11
:
00
30
AM
PM
Total Number of Participants
Total Number of Residents
Total Number of Commuters
Facilities Request
*Actual capacities will vary dependent upon the specific room set-up
Check the Facilities You Are Interested In:
Kraushaar Auditorium - capacity 962
Merrick Lecture Hall - capacity 223
Rosenberg Gallery - capacity varies based upon event requirements
Athenaeum Hyman Forum - capacity varies based upon event requirements
Athenaeum Batza Room - capacity 65
Alumnae/i House Buchner Hall - capacity 70
Alumnae/i Scheeler Board Room - capacity 12
Kelley Lecture Hall - capacity 144
Classroom Space - capacity 1-40
Beldon Turf Field
Beldon Turf Field Lights
Gopher Stadium
Gopher Stadium Press Box/Scoreboard
Gopher Stadium Track
Grass Practice Field (three available)
SRC Decker Arena
SRC Room 209 - capacity 35
SRC Lilian Welsh Gym
SRC Multipurpose Room - capacity 100
SRC Varisty Room - capacity 40
Aquatic Center - capacity 75
Tennis Court
Other Campus Space
Parking Spaces Needed
Indicate Estimated Number
Housing Request
Available late-May through July 31
Single Rooms
Enter Number of Single Rooms
Double Rooms
Enter Number of Double Rooms
Arrival Date
Departure Date
Dining/Catering Requests
Date of First Meal
Indicate First Meal
Breakfast
Lunch
Dinner
Date of Last Meal
Indicate Last Meal
Breakfast
Lunch
Dinner
Prefer a dedicated, catered meal
Yes
No
Note: The Organization agrees to use Goucher College’s on-campus food service provider (Bon Appetit) as the exclusive food service provider for the duration of the Program.
Additional Equipment/Service Request
Please describe any audio visual, sound, lighting, and/or other equipment and/or service your Program will require. Include the type(s) of equipment and the date(s) and time(s) each item will be needed.
Special Accommodations
Please describe any special accommodations your Organization may require, such as first floor residential accommodations, dietary restrictions, accessibility concerns, etc.
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