Screening Room Request Form - School of Communication and the Arts, Regent University, VA

Please submit your request no later than the Monday prior to your requested session(s).

All fields are required.

Date/Time: 11/21/2009 23:13:53

Screening room:	"A" (seats 91) "B" (seats 42) "C" (CTV Dailies)
Requested by:
Faculty:
School/Dept.:
Class Name/#:
Contact Phone #:
Regent Email:	@regent.edu

Requested Date(s) of Reservation:
Requested Times:
Set-up Time:
Media Start Time:
Media End Time:
Estimated End of Reserved Time:

Purpose of Reservation:
Type of Presentation:
IF SELCTED RU Film(s) & Commercial Film(s):
Title:
Length:
Format:

NOTE: If this is a Commercial Film...
Will this screening be a part of a regularly scheduled University class discussion led by the Instructor of that class dealing with the specific content or style of the film? Yes No
If the answer to the question above is "No", have you obtained proper licensing for this film? Yes No
Please forward a copy of the Licensing Agreement to COM Bldg. Operations Mgr. at least 24-hrs prior to the scheduled Film Screening. Rick Hall – COM-221

Number of People expected to attend the Screening:
Special Requests:

I have read and do understand the policies set forth by the School of Communication & The Arts for use of the Screening Room(s) and, with submission of this form, attest that I take full responsibility to make sure that my group abides by these policies and leaves the room in the same condition as it was found. I further agree to make a check available, in advance of my event, for any applicable room and/or personnel charges levied for use of the room. I further understand that failure to abide by any of the policies set forth in the attached document may result in a $100 surcharge.

I understand and agree:

Do you need Keycard Access to Screening Area?

Note: Students currently enrolled in the Cinema/Television program may already have Keycard access to the support rooms required for each specific class. Please check with your Professor.