Suffolk University - Classroom Request Form

Event and Contact Information:

*Name of Requestor:

*Organization Name:

*Please provide a description of the organization, including any information regarding the educational nature of the organization.

*Email Address:

*Phone Number:

*Organization Address:

*Program/Event Title:

*Type of Event:

*Please provide a description of the program that you are seeking to offer at Suffolk, including any information regarding the educational nature of the program.

Classroom Style Requested:

*Day of the week: (Please check all that apply)

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

*Date of Event:

*Start Time:

*End Time:

Are additional dates/times needed? If yes, specify:

*Is your organization a non-profit organization, specifically a 501(c)(3) organization, a for-profit corporation, a government entity or other (please explain)? (If a 501(c)(3), a certificate issued by the Internal Revenue Service will be required):

*Is this event open to:

Anticipated number of guests:

*Suffolk Community:

*Non Suffolk Community:

*Total:

*Are the participants under 18 years of age?:
If so, what is the age range:

Yes No

Will Food Service be needed?:

Yes No

Will media be needed?:

Yes No

Comments/Special Details:

Classroom	Size	Hour	Half Day (4 Hours)	Full Day (8 Hours)
Small	11 to 30	$40.00	$85.00	$140.00
Medium	31 to 50	$85.00	$140.00	$195.00
Large/Sawyer & Café	80/427 & 429 (100 - combined)/Sawyer Lounge/Donahue Café	$110.00	$165.00	$250.00

Note: A 10% discount is available to not-for-profit groups.