Reservation Form - Duke University Student Affairs

By Howard Ford,2014-09-28 05:27
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Reservation Form - Duke University Student Affairs

    LGBT Center Reservation

    Contact Information:

    Name: ______________________________ Telephone: ______________________

    E-mail: _____________________________ Duke Unique ID: _________________

    Organization: ________________________ Fund Code: _____________________

Reservation Details:

Conference Room

     Kitchen (use does not include LGBT Center disposable products, foods, etc.)

    NB There is no refrigerator available for use. If food items must be kept cold,

    please remember to bring coolers and ice.

     Reception Desk/Lounge area

Will you be serving food? ;;No Yes Your Caterer: ______________________

    Date(s) of event: _____________ Time: _____ to _____ (include setup and cleanup)

Anticipated Number of attendees: ________________

    Please contact 684-6607 if plans change and you no longer need to have the doors opened as scheduled above.

    LGBT Center ALCOHOL POLICY: There will be no alcoholic beverages served in the Center for LGBT Life at events sponsored by undergraduate groups. Graduate groups may serve alcohol if dispensed by a Duke-approved bartender.


    WHICH YOU FOUND IT! (Cleaning supplies are located behind the kitchen door and under the sink.) Return tables and chairs to their original positions. Failure to abide by the attached damage contract and values statement will constitute forfeiture of future reservations for one year.

For office use only:

    Reservation accepted by: _______________________________ Date: ___________

     LGBT Center Staff

Damage contract read and signed

     Values statement read and signed

     Copy of signed document given to Duke Department/Group Representative.

    Contact Peg Helminski, LGBT Center Staff Specialist 919-684-6607 if you have

    questions or need to make changes to your reservation.

     After hours event: door will open 15 minutes before requested time and lock 15

    minutes after ending time.

    Page 1 of 3

    LGBT Center Reservation

    DukeCard office notified: ;;;No Yes Date: _______


    The Center for LGBT Life realizes that on a diverse, multicultural campus like Duke, many people have differing opinions, beliefs, backgrounds and philosophies. We hope that our space will be utilized to explore these values and share them in a respectful and non-judgmental way. In keeping with our mission, the LGBT Center has been deemed a safe space for lesbian, gay, bisexual and transgender people and their affirming allies. We expect that groups using our space, at any time during the week, will hold events and activities that are inclusive. We hope you will create an atmosphere wherein LGBT members of your group or department can exist free of harassment, prejudice, and discrimination. People, including LGBT people, should be allowed to express themselves in a respectful manner that also upholds the community standard at Duke University. If you have any questions about this or think you may have difficulty in upholding these values, we will respect your decision to withdraw your reservation for use our space.


    The Center for LGBT Life welcomes your usage of our space. We, (hereafter called “LGBT Center Staff”) inform you ___________________________ (hereafter called “Duke Department/Group”) that it is your sole responsibility that the LGBT Center is RETURNED TO THE STATE IN WHICH YOU FOUND IT AND THAT ALL EQUIPMENT


    1) ART: If any artwork displayed in the Center is broken, defaced or missing, the

    Duke Department/Group will be responsible for replacement and/or insurance


    2) You are responsible for clean-up after your event.

    a. All tables should be wiped off if you have drinks or food at your event.

    Cleaning supplies are located under the sink in the kitchen.

    b. All dishes, cookware & utensils used should be washed and placed back

    where they were found. (Sorry, we are not able to share paper products.)

    c. All trash should be bagged and placed by the stairwell in the basement

    outside of the Center or in the dumpster under the Plaza.

    d. All lights should be turned out and all doors secured after an event.

    The LGBT Center staff will inform your group via e-mail if any furniture is not replaced properly, clean-up was inadequate or if equipment or artwork is missing or damaged. The Duke department/group will be required to immediately arrange furniture and/or

    clean. Missing equipment or artwork will be returned by the end of the business day or a Duke Police report will be filed and the Duke department/group will be charged for replacement.

Audio/Video/Computer Equipment and Art:

    Front Room:

    SONY/VIDEO CONTROL CENTER Apple Airport Express

    2 POLK AUDIO SPEAKERS 1 Ricoh printer/copier/fax

    1 APPLE IMAC COMPUTER 1 HP Deskjet 995ck Printer

    2 Black/White Photo Prints 16 Framed Color Photos

    5 matted works of original art ___ Additional Art (If applicable)

    Conference Room:



    Page 2 of 3

    LGBT Center Reservation


    I, ___________________________, agree and my Duke department/group accepts financial responsibility for all mentioned above, and the entire LGBT Center during my rental period. I have also read and agree to the Space Usage Values Statement.

    Date: ____________________ Phone # _____________________________________

    Signature: _____________________________ Email___________________________

    LGBT Staff Approval: ____________________________Date: ___________________

    Conference Room: Please return furnishings to this configuration after use.

     Easy Door Recycle Chair

     4 Easy chairs

     TV Burgundy arm chairs Couch Coffee 6 large tables table


     Sm table Books


    Table 4


    w/ Door

Door Trash Closet Gr



    ckPage 3 of 3




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