Off Campus Activity Notification Form Please complete this Off Campus Activity Notification Form at least 14 days prior to your organization's activity. A Student Activities staff member will contact you about your activity. If you have any questions, please contact offcampusactivities@uconn.edu. Step 1 of 2 50% Name* First Last Student Organization (no acronyms please)*Officer Position*PresidentVice PresidentTreasurerSecretaryPhone*Email* Is the Activity Planner the person listed above?*YesNo. There is a separate Activity PlannerActivity Planner Name* First Last Activity Planner Email* Activity Planner Phone*Off-Campus Activity InformationTitle/Description of Activity*What is your organization's role in this activity?*My organization is HOSTING the activityMy organization is CO-HOSTING the activity with another organization(s)My organization is ATTENDING this activity (hosted by another organization)Estimated Total Attendance at Activity*Estimated Organization Attendance at Activity*What organization(s) is/are CO-HOSTING the activity with your organization? (no acronyms please)*Name of CO-HOSTING organization's Activity Planner* First Last Co-hosting organization's Activity Planner Email Address:* Co-hosting organization's Activity Planner Phone Number:*Start Date* Date Format: MM slash DD slash YYYY Start Time (estimated departure from UConn)* : HH MM AM PM End Date* Date Format: MM slash DD slash YYYY End Time (estimated arrival back at UConn)* : HH MM AM PM How frequently does this Activity occur?*One- TimeWeeklyBi-WeeklyMonthlyPlease list the dates and times here*Please describe what will happen at this activity*What is the name of the location/venue/business where the activity is taking place?*Activity location* City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Has your organization used this venue before?*YesNoI don't knowWho will be attending this activity? (more than one answer is okay)* My organization's members Other UConn students UConn staff/ faculty General public Other Off-Campus Activity DetailsTransportation InformationHow will your members or attendees travel to the location? (check all that apply)* Organization is providing transportation for attendees Attendees are driving themselves in their own cars Attendees are carpooling Other Please explain*Lodging InformationWill participants be staying overnight somewhere during the course of the activity?*YesNoWhat is the name of the lodging location?*What is the address of the lodging location?* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Has your organization stayed at this lodging location before?*YesNoIs the activity taking place at a different location from the lodging?*YesNoHow will attendees travel to and from the activity venue to the lodging location?*Minors InformationWill anyone under the age of 18 be participating in the activity?*YesNoWhat is the nature of their participation in the activity?*Alcohol InformationWill alcohol be present at the activity?*YesNoHow will the alcohol be paid for?*How will alcohol be distributed?*Who will be serving the alcohol?*If you are having a server, is the server licensed to serve alcohol?*YesNoI don't knowIs there a "cash bar"/ "open bar"?*Cash bar (alcohol provided by a third party vendor at a cost per beverage to participants)Open bar (alcohol provided by third party vendor at no cost to participants)NeitherWill participants be permitted to bring alcohol to the activity?*YesNoWhat steps will be taken to ensure that ONLY individuals 21 years of age or older are allowed to consume alcohol?*Food and Beverage (non-alcoholic)Will food and beverages be provided at the activity?*YesNoWho will provide the food and beverages?*Fundraising InformationIs your organization collecting money at this activity?*YesNoWho is receiving the funds? (please check all that apply)* My organization Another organization (charitable donation) Other Please explain.*ContractsHas your organization already / will your organization be entering into or signing any contracts or agreements for this activity (ex. caterers, hotels, performers, transportation companies, etc.)?*YesNoI don't knowPlease list each of the entities with whom your organization will be entering into a contract or agreement.*Who will be signing (or has signed) the contract(s) or agreement(s)?*SecurityAre you required to provide security (public or private) for any aspect of this activity (ex. police, private firm, etc.)?*YesNoI don't knowWho is requiring your organization to have security at this activity?*Please list the entities you are planning to have provide security.*FundingIs this activity supported with USG funding?*Yes- the funding has been approvedI don't know- we have requested funding and are waiting to hear backNoIs there a charge to get into the activity?*YesNoPlease explain.*