Facility Rental Request Name* First Last Organization/Company Name*Your affiliation with the organization/company*Organization/Company Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* Starting Date* MM slash DD slash YYYY Set-Up Time* : Hours Minutes AM PM AM/PM The time the space will be needed for set up. Starting Time* : Hours Minutes AM PM AM/PM When general public and/or participants will be allowed into the facility. Ending Date MM slash DD slash YYYY Ending Time* : Hours Minutes AM PM AM/PM Time at which the facility will be vacant off all members associated with event. Multi Day RequestsIf your requesting is a multi-day event, can you please include all of the request in this space. Be specific with setup times, event times, and tear down times. Event Name*Description of Event*Please be very specific about the equipment needs for the events, if you will be charging for admission/participation fees, ages of the participants and if you plan on having a concession stand. Will you be selling or providing food at this event?*YesNoIf the event will require concessions, user must either utilize a food service provider approved by UWM’s Purchasing Office or, if user wishes to provide its own food service, it will be limited in regard to the type and extent of food service that it may provide. In general, food service will be limited to pre-packaged non-perishable items (e.g., candy bars, canned soda, etc.). UWM strictly prohibits the sale of “home-cooked” foods. PLEASE INCLUDE DETAILS FOR FOOD IN THE DESCRIPTION OF AN EVENT AREA. The event will include* UWM Students Non-UWM Students Minors (non-matriculated youth under age 18) Other Facility needed* Arena Pool Klotsche Classroom Group Exercise Room Cycle Room Racquetball Courts Pavilion Gym Engelmann Gym How many participants are you expecting?*Please enter a number less than or equal to 3000.If you are a non UWM Organization do you have certificate of insurance that meets UWM's minimums?The minimums can be found at http://uwm.edu/risk-management/insurance/certificates-of-insurance/