Page 1 of 4

Application for the use of the Industry & Technology Center

Name of Event

Name of Organization/Group/Department

Contact Name

Phone

Email

Alternative Phone

Address

Type of Event

Type of Event
A
B
C
D
E

Event Date

Number of Participants

Arrival Time

Departure Time

Space(s) Requested

Space(s) Requested

Are participants charged a fee?

Are participants charged a fee?
A
B

Will refreshments or a meal be available?

Will refreshments or a meal be available?
A
B