Facilities Request Form

Please complete this form and submit it by pressing the Submit button at the bottom of the page. To allow enough time for processing, requests must be received two weeks prior to the event. If you have questions, please phone Cheryl at x3994.

To obtain a printed copy of your request, press the SUBMIT button below after filling out the form. A copy of your request will be repeated back to you. Then press the PRINT button on your browser.

Please note: If you have additional attachments to accompany this request, please email the documents to mdixon@fnal.gov.

**required

**Today's Date:

**Requester's Name:

**Fermilab ID #:

**Phone #:

**E-mail Address:

**Mail Station:

**Name of Event:

**Estimated Attendance:

Dates of Event:
**Day 1 Date **Time Begin **Time End
Day 2 Date Time Begin Time End
Day 3 Date Time Begin Time End
Day 4 Date Time Begin Time End
Day 5 Date Time Begin Time End
More Days Dates Begin Times End Times

Facilities Requested: (Meeting Rooms, Chez Leon, Music Room, etc.)
Some rooms do not have AV equipment. Please check with VMS.
There are lights that show the status of the HVAC for 1 West on the front wall and an on/off switch for the system.  See photo.


**Day 1 Facilities Requested (list all):
Day 2 Facilities Requested (list all):
Day 3 Facilities Requested (list all):
Day 4 Facilities Requested (list all):
Day 5 Facilities Requested (list all):
Day 6 or more Facilities Requested (list all):

Please note: Listing a meeting room on this form does not book the room. You are responsible for booking a room by calling the appropriate room contact person.

Is setup time required? Yes No
If yes, what time will you require access?

Requested Setup: (i.e., tables, chairs, etc.)
Done by Janitorial Service
Project/Task Code for Janitorial:
Please note: Requester must contact Janitorial to request specific setup requirements
Done by Requester/Group

Details of Setup:

Audio Visual Requirements (Please be specific):

Project/Task Code
for AV:
Please note: Requester must contact VMS to request specific AV requirements

Special Networking Requirements (Please be specific):


Recreational Equipment or Facilities Needed (Please be specific):

Project/Task Code
for Recreational Equipment:

Security Issues:
Additional Security Personnel -- Details:
Parking -- Details:
Traffic Control -- Details:
Directional Signs -- Details:
Project/Task Code for Security:

**Will alcoholic beverages be available? Yes No    
List specific times for serving (maximum 4 hours)
Please note: 4 hour maximum for alcohol. Alcoholic beverages must be purchased through food service subcontractor and dispensed by a certified server.

Name of Certified Server:

Food and beverages requested through:
Please note: Fermilab organizations intending to use contract funds for meeting refreshments, meals or continental breakfasts must adhere to the "Use of Contract Funds for the Provision of Refreshments and Meals at Fermilab Hosted Meetings" policy.

Food Services Subcontractor
Project/Task Code
-OR- Pay Cash

Chez Leon
Project/Task Code
-OR- Pay Cash

Other (outside the lab)
Project/Task Code -OR- Pay Cash

Please list food and beverages requested:

Please note: Requester must contact food service provider to request food and beverages

Will you require janitorial cleanup? Yes No
Project/Task Code
for Cleanup:


To obtain a printed copy of your request, press the SUBMIT button below after filling out the form. A copy of your request will be repeated back to you. Then press the PRINT button on your browser.