Event Registration Form

EVENT CONTACT

Full Name(*)

Please enter your name.

Phone Number(*)

Please enter your phone number.

Email (@uab.edu email address)(*)

Please enter a valid email address.

EVENT DETAILS

Event Name(*)

Please enter a name for the event.

Event Location(*)

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Venue/Facility(*)

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University Representative that will be present and responsible for event compliance (Full Name)(*)

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University Representative Email (*)

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Type of Event/Description(*)

Please describe your event.

Event Start Date(*)

Please enter the start date for the event.

Event End Date(*)

Please enter the end date for the event.

Estimated Number of Attendees(*)

Please enter the estimated Number of attendees.

Will Food and/or beverages be served at event?(*)

Yes

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If yes who is the caterer?

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ACKNOWLEDGEMENTS

(*)

Event acknowledges that it has read and will comply with UAB Freedom of Expression and Use of UAB Facilities Policy

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(*)

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