Please note that completion of this form does not guarantee approval of your request for an event at the Davis Museum. Please contact Dave Accorsini (daccorsi@wellesley.edu) ext. 2080 if you have any questions.

Name of Person Making Space Reservation Request

Email

Phone Extension


Department

Short Title of Event

Full Title of the Event

Type of Event
Announcement Class (non-credit) Concert Conference Session Dinner Exhibit Film Lecture Meeting Reception Tour

This event is open to:
General Public
Wellesley Only
Closed

Primary Organization

Budget #


Description (provide a detailed description - as you would for a newspaper advertisement, etc.)

Date of Event

Start Time of Event


End Time of Event

(Set-up time)

(Post-event time)

Space requested
Collins Cinema Collins Cafe Museum Lobby Plaza Seminar Room (212) Print Study Contemporary Gallery Towne Gallery Bevington/Duncan Bronfman Chandler Ramer Shapiro Tanner Wolfe

Estimated attendance


Special Services (please specify your exact needs) custodial, campus police, tip server, tables/chairs, etc. Some of these services will be required at your expense and charged to the budget # listed above. Please contact the college club for catering services

Media Questions - please complete ONLY if you require computing or A/V equipment

Equipment must be ordered 48 hours in advance. A lead time of 5 business days is required for a videographer, projectionist or technician. Information on this form regarding media requests will be communicated to the Media Services Department by the event scheduler. It is your responsibility to confirm this request or any changes to your reservation with the Media Services Department (ext. 2369). For more information on media, visit the Media Services website at: http://www.wellesley.edu/Knapp/mediaServ.html

For events involving major technical requirements, an AV technician may be asigned. You will be contacted if this is necessary. There is a charge for this service.

Will you require any of the following media or other equipment?

Thank You!