MD Student Organization Event Request
Organizer Info
Name of Student Organization
Event Contact Person
Phone Number
In case of conflict
Email Address
Campus
Please select...
Hershey
University Park
Event Info
Type of Event
Please select...
Community Event
Fundraiser
Lecture
Organizational Meeting
Other
Please specify
Event Title
This is what will be displayed on the calendar
Event Description
Please include 2-3 sentences describing your event. Be as specific as possible
Please explain how the event/benefiting organization relates to the university's or hospital's mission of education, research and health care
Has the event been discussed with the group faculty adviser(s)?
Yes
No
Proposed Event Start Date & Time
Proposed Event End Date & Time
Proposed Location
See http://infonet.pennstatehershey.net/web/room-scheduling for possibilities
Alternate Event Start Date & Time
Alternate Event End Date & Time
Alternate Location
See http://infonet.pennstatehershey.net/web/room-scheduling for possibilities
Additional Comments
Contact Information