Reservation Request Form

Please fill out this form to send a reservation request for
Atkinson Hall's specialized facilities on the First Floor.

* Denotes required fields.


*Event title:

*Contact person:

*Contact email:

*Contact affiliation/department:

*Recharge index number:
-
(UCSD recharge number must include a three-letter perfix, and a combination of 4 alpha-numeric characters in the right box)

*Fund manager name:


*Fund manager email:

Event start date and time:
:

Event end date and time:
:

Room requested:
Calit2 Theater (The Black Box)
Pre-Function Area (PFA)
Calit2 Auditorium

Event type:

Estimated number of attendees:

*Target audience:

Industry participation: (please list any companies expected to be represented among attendees)

Public or private event?

*Event description:

*Reason for hosting event at Calit2:

*How is the event related to Calit2's Statement of Purpose for Public Spaces?

Event website:

Calit2 logistics needs:

Audiovisual requirements:

Other info:


*We are interested in knowing how your event will impact specific target areas that support Calit2's mission. Please Check all the items that are applicable if your event is intended for:











Please select at least one item.