Reserve the Center | H. Fred Simons African American Cultural Center

AACC Room Reservation Form

* PLEASE NOTE THAT DUE TO COVID-19 THIS SUBMISSION IS SUBJECT TO CHANGE AS PER UNIVERSITY OF CONNECTICUT'S STUDENT UNION PROTOCOL * RESERVATION FORM MUST BE SUBMITTED AT LEAST 48 HOURS PRIOR TO PROGRAM * YOU WILL RECEIVE CONFIRMATION FROM STAFF ABOUT THE STATUS OF YOUR REQUEST. THE ROOM IS ONLY RESERVED IF STAFF REACHES OUT DIRECTLY TO GRANT YOUR RESERVATION

This form must be filled out at least ten days prior to the event. You must be a University of Connecticut registered student organization or department to reserve space in the African American Cultural Center.
Today's date*
MM slash DD slash YYYY
Is today's date 7 or more days before the program?*
- Yes
- No
Please submit the form a week before the program
Which room at the center are you requesting?*
- Community Room
- Conference Room
- Study Lounge
- Kitchen
Department or Organization*
Name of person making request?*
First Last
Affiliation with organization or department*
Email*
Phone*
Does this event involve additional departments or organizations?*
List all additional departments and organizations involved and their contact person(s), email(s), and phone number(s):*
Program date*
MM slash DD slash YYYY
Program start time*

: Hours

Minutes

AM/PM
Program end time*

: Hours

Minutes

AM/PM
Alternative date
MM slash DD slash YYYY
Alternative program start time

: Hours

Minutes

AM/PM
Alternative program end time

: Hours

Minutes

AM/PM
Title of Event:*
Briefly describe the program or event*
Is this a reoccurring event?*
- Yes
- No
Last date of reoccurring event*
MM slash DD slash YYYY

The African American Cultural Center reservation policy only allows student organizations to book for the semester, not the academic year.
Admission charge*
- Yes
- No
Expected attendance*
Setup request
- Chairs
- Podium
- Microphone
- Round tables
- Square tables
Including changes to the typical set up.
Special requirements
Kitchen Policies
- There should be absolutely no horseplay or other inappropriate behavior in the kitchen.
- There should be absolutely no shouting or screaming while using the kitchen.
- Guests must always make sure that the kitchen is spotless after use.
- Gloves must be worn at all times. Hands must be washed and sanitized before, during and after cooking.
- All kitchen surfaces should be wiped down and sanitized before and after cooking. This includes but is not limited to: counters, cabinets, tables, chairs, and appliances.
- Garbage should be disposed of appropriately.
- All personal cooking items should be removed once cooking is finished. All items left in the kitchen are subject to immediate removal.
- Food should not be left in the sink or pushed down the sink drain. There is a food basket in the drain that should remain there so that it catches food while cleaning. Empty as necessary.
Warnings
- Kitchen and hallway smoke detectors should not be removed or disabled for any reason. Do not hang items from sprinkler head and/or fire detection/fighting equipment. Smoke detectors are sensitive to airborne particles such as hair spray. Intentional or accidental activation of and/or tampering with any fire detection device may result in disciplinary action and/or paying for associated repair costs. Any problem with a smoke detector should reported to the AACC staff.
- Do NOT drop anything on the stove. It is a glass-top appliance and if misused, may break very easily. Any and all damages will be paid for by the individual or organization responsible. There are no exceptions to this policy.
AACC Facility Usage Policies
I, the undersigned, apply for permission to operate a concession or engage in a fund raising project on the campus of the University of Connecticut as described, and upon approval, agree to comply with policies and procedures of the University when operating a concession. Failure to do so will result in withdrawal of said privilege. I have authority to commit funds and reserve facilities on behalf of the registered Student Organization or University.

I agree to comply with all deadlines, agree to pay support service charges, and comply with all local, state, and federal laws and University policies. Failure to comply with deadlines and policies will result in cancellation of the reservation. If it is reported that my organization does not take steps to comply with the laws and policies, or if the organization disregards instructions given by staff assigned to the event, or if personal injury or property damages occur, then the organization will be held responsible and liable for damages, and will be denied use of the facilities for up to one semester.

I have read and agreed to comply with facility usage policies, and I will be present during the entire event to ensure the group enforces the policies
Digital Signature*

I hereby certify that the above statements are true and correct to the best of my knowledge.
Director Approval*

Type X above. This space is for the Director's signature.
Phone
This field is for validation purposes and should be left unchanged.