Ellison Chapel Reservation

Today's Date

Account Information

BU Account Number

Organization requesting usage

Is this a chartered organization?

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone

Contact Name

Contact Phone

Contact Email

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Organization Faculty/Staff Advisor Name

Date

Date
Date

Set Up Start Time

Event Start Time

Event End Time

Clean Up End Time

Name of Event

Purpose of Building Use

What is the nature of your event?

Number of People Expected

Will you be needing access to the 70" TV?