* Your Name:

   Your Organization:

 * Telephone:

    email Address:

  * Mailing Address:

    Event Name:

 * Date(s) of Event: 

 * Approximate Number of Attendees:

 * Actual Time(s) of the Event (please state beginning and end time):

 * Time(s) You Will Need Access to Building (please state beginning and end time):

   Special Set-up for Stage (if needed):

   Please check the appropriate box(es) below for room set-up.

  Head Table      Number of Chairs:

  Audience Seating
  Tables with Chairs on Both Sides

  Tables with Chairs on One Side (facing front)

  Round Tables with Chairs (each table seats 6)

  Chairs Only

   Please check the appropriate box(es) if you need the following audio/video equipment.

  Podium with Microphone

  Lapel Microphone

  Screen/Projector for PowerPoint or Computer Presentation

  Laptop Computer for PowerPoint or Computer Presentation

NOTE: The Carrasco Room is located in the Scharbauer Student Center, on the Midland College campus.

Please adhere to designated parking spaces.
Vehicles are not allowed on sidewalks or grounds of Midland College.