Fillable Printable Event Application1

Event Application1

DEPARTMENT OF TECHNOLOGY, MANAGEMENT & BUDGET FACILITIES and PROPERTIES

APPLICATIONS MUST BE RECEIVED 14 DAYS PRIOR TO THE EVENT

Applications can be faxed to (517) 241-5639 to the attention of the Events Coordinator, or mailed to:

Events Coordinator, Office of Infrastructure Protection, JOC, 615 W. Allegan St., Lansing, MI 48933

Event Name

Event Date Event Time

From ________ To _________

Organization Name and Address Website

Event Contact Name (printed)

Contact Address

Contact Telephone No. Fax No. Email

Nature/Purpose of Event

Area Requested (Facility, Conference Room, Parking Lot, etc.)

Number of Attendees (including event staff) Parking Requirements (No. of spaces)

Equipment you will be providing (tents, portable bathrooms, etc.)

Backup Contact Name (printed)

Address

Telephone No. Fax No.

I have read and understand Administrative Rule 0210.06 Conduct on State Property,

the general guidelines and provisions, and agree to abide by them.

Event Contact Name (signed) Date

For Department of Technology, Management & Budget Use Only

Events Coordinator Notes:

Approved Denied

Signature, Office of Infrastructure Protection Director

Approved Denied

Signature, Building Operations Director

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A policy that is attached to this form is available at:

hp://www.michigan.gov/documents/dmb/0210.08_Obtaining_Wrien_Authorizaon_390409_7.pdf

EVENT APPLICATION

Questions? Call (517) 335-6735

DTMB-0451

Revised: February 2013