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Conference Center Rental Request Form – External
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Conference Center Rental Request Form – External
Campus Location
(Required)
Fond du Lac
West Bend
Contact Name
(Required)
First
Last
Phone
(Required)
Email
(Required)
Business Name
(Required)
Business Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Federal Tax ID # (Not Sales Tax Exempt #)
(Required)
Have you rented space at MPTC before?
(Required)
Yes
No
Is your organization a Non-Profit 501c?
(Required)
Yes
No
Will there be any government officials attending your event?
(Required)
Yes
No
If yes, list their name(s):
Name of Event
(Required)
Start Date of Event
(Required)
MM slash DD slash YYYY
End Date of Event
(Required)
MM slash DD slash YYYY
Event Start Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
This is the time the event actively begins.
Event End Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
This is the time the event actively concludes.
Event/Meeting Duration
(Required)
4 hours or less (Half Day)
8 hours or less (Full Day)
8+ hours
Reservation Start Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
This is the time the organizer will arrive for the event prep/setup.
Reservation End Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
This is the time ALL event activities will be completely done and all attendees will be gone.
Number of Attendees
(Required)
Technology / IT Contact Name
First
Last
Technology / IT Contact Email
If you have any technology needs, please select them below.
Projector
Podium w/ Microphone
Laptop Audio
Select which Room Layout you will need.
Theatre
(no tables - FDL maximum 450 seated, WB maximum 330 seated)
Classroom
(tables & chairs - FDL maximum setup 180, WB maximum setup 80)
U-Shaped
(depending on room orientation)
Mini U-Shape Pods
(6 people per pod - FDL maximum 30 pods, WB maximum 13 pods)
Rectangular Banquet
(4 people per table - FDL maximum 45 table sets, WB maximum 20 table sets)
If other Room Layout is needed, please explain:
Accessibility accommodations needed:
Designated Seating for Wheelchair
Sign Language Interpreter
Assistive Listening Device
Captioning Services
Accessible Presentation Materials
Service Animal Accommodation
Seating near the front of the room
Dietary Accommodation
Bariatric Chair
Ergonomic Chair
Swivel Chair
Adjustable Footrest
Room Lighting Accommodation
Please list any anticipated decorations, displays, etc.
Additional requests or questions, please note them here.
If you have an Event Script / Meeting Agenda File, please upload below:
Max. file size: 50 MB.
If using a caterer, please provide the caterer name below:
Catering Information
It is strongly encouraged that external non-college organizations utilize Moraine Park’s contracted on-campus caterer before any outside catering service. Menus, ordering process, contact information and billing information can be found at
https://mptc.catertrax.com
. All inquiries, requests and orders shall be made in direct contact with the contracted caterer. MPTC does not provide coordination service between the requestor and the catering company. In the event our on-campus caterer cannot make accommodations to cater your event you will be promptly notified. External non-college organizations, at their discretion, are may hire outside 3rd party catering companies for their events.
Consent
I understand that this form does not guarantee a reservation.
I understand that an MPTC Representative will be in contact with me about this request and I can follow-up by calling 920-924-3221 if needed.
I agree to the terms of the Liability/Insurance Requirements.
I agree to the terms of the
Rental Guidelines
I agree
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