1 Merritt College 12500 Campus Drive Oakland, CA 94619 (510) 434-3967 Facilities Rental Overview: Internal Reservations For Merritt Student Clubs, Programs, Departments Only PROCESS OVERVIEW Please read in entirety before submitting your request and do not advertise event until application has been submitted and approved. Request Deadlines All Application for Use of Facilities forms must be turned in 30 days prior to scheduled use in accordance with Peralta District Board Policy 6.64. Any applications not received within this timeframe will be processed at the discretion of staff and may be denied. Rental Process 1. READ, SIGN & DATE the Facilities Rental Overview Form. 2. TENTATIVE HOLD for the date requested can be placed for two weeks to allow time for submission of the Application. 3. COMPLETE the following forms: the Peralta Community College District Application for Use of Facilities/Contact Info, Facilities Rental Needs form, AV Support form and Room Setup form at least 30 days prior to your event date. 4. Co-Sponsored Events: COMPLETE the Contact Information for the Internal Event AND the Community Partner Contact Information Sheet for external organization(s) participating in a co-sponsored Merritt College internal event. Co-Sponsored Events must be approved by the College President or VP of Instruction or VP of Student Service or Director of Business & Administration Services. 5. SUBMIT the above-mentioned forms to the Dean of Sp. Programs, Student Life Director, or VPSS for reservations by student organizations; and to appropriate Dean, Program Director or VPI for reservations by faculty/staff; and to Business Office Director for reservations by the District Office. Approval is required for authorization as an official Merritt College Internal event. 6. Please provide Department Accounting code to charge overtime costs or deliver a check to Business Office if the Event either starts and/or ends after 3pm on Saturday OR ON any day the campus is closed (i.e. Sundays, Holidays, 3-day week end during Summer Schedule, etc. Per Union Contract, the following fees will apply: a $60 open up/set up and $60 clean/close/lockup custodial fee and a minimum $240 IT/AV Technician Fee if the School s Audio Visual (AV) equipment is used for the event. The IT/AV Tech fees will also apply if the IT/AV Tech is needed after 4:00pm any day of the work week. $150 Athletic Supervisor Fee applies if Athletic facilities are used. Request Deadlines All Application for Use of Facilities forms must be turned in 30 days prior to schedule use in accordance with Peralta District Board Policy 6.64. Any application not received within this timeframe will be processed at the discretion of staff and may be denied. Please note: During rental time, all college policies and regulations must be observed. It is expressly forbidden for renters to subcontract to other organizations, groups, or individuals. If an external organization/outside group is NOT a community partner in an approved co-sponsored event and participating in an internal event, the external organization/outside group must complete the External Rental Application and follow all steps outlined in the External Rental Application/Process. Alcoholic beverages and controlled substances are prohibited on all Peralta Community College District property and within District facilities. No smoking or cooking inside any of the school facilities that may activate smoke detectors and incur additional charges if Fire Dept. is alerted. No PETS are allowed on College premises. Parking All parking regulations are strictly enforced by the Alameda County Sheriff s Office/ Peralta Police Service. Continuing violations of parking regulations by a group may result in cancellation of the group s rental agreement. Security Services Monday-Friday call Police Services 510-466-7236 / Saturday-Sunday call Securitas at 510-866-1016 I have read and understood the above. Signature: Date:
2 MERRITT COLLEGE Application for Internal Use of Facilities CONTACT INFORMATION (complete the Community Partner Contact Information sheet for Co-Sponsored Events) Name of Merritt College Applicant: Title: Date: Name of Merritt College Student Organization/Program/Department: Phone: Cell Phone: E-mail: Address: City: State: ZIP Code: EVENT INFORMATION Type of Event: Date of Event: Type of Facility Requested: Start and End Times of Event: Time Facility to be Opened: Time Facility to be Closed: Number of people expected: Is Merritt College Co-Sponsoring this event If yes, to previous question, Name of Community Partner: with a Community Partner? CIRCLE ONE: YES NO Other External Organizations must complete and submit an external application packet If Personnel Overtime Costs are incurred, per item #6, page 1 of app. packet, Who is responsible for these over-time costs? IRS Tax Exempt Status? CIRCLE ONE: YES NO If Community Partner is responsible for personnel overtime costs, have they been advised? State the nature of use, title of performance, names of speakers, as appropriate. Describe fully. Use reverse side if necessary. Are Contributions, collections, dues, registration fees or other donations to be received? CIRCLE ONE: YES NO Amount per Attendees? $ Estimate Total $ The applicant shall be held responsible for any and all loss, accident, neglect, injury or damage to person, life or property which may be the result of, or may be caused by his or its use or occupancy of the herein described premises. The applicant agrees to protect, defend and identify Merritt College and the Peralta Community College District, its officers, employees and agents, and save them harmless in every way from all suits or actions at law for damage or injury to persons, life or property that may arise or be occasioned in any way because of his or its use of said premises. The undersigned states that, to the best of his knowledge, the school property for the use of which application is hereby made will not be used for the commission of any act which is prohibited by law, or for the commission of any crime. I certify (or declare) under penalty of perjury that the foregoing is true and correct. Signature of Merritt College Employee: Date: COLLEGE USE ONLY IT Tech Needed / Custodial Services Needed after normal work week hours and/or Event Starts/Ends after 3pm on Saturday or when the campus is closed (e.g. Sundays, Holidays, 3-day week end during Summer Schedule, etc.)? If yes, please advise that costs will be incurred (see #6, page 1 of packet) If Co-Sponsored Event/Internal Event, Community Partner Contact Info Sheet Received? Yes No Initialed Personnel Costs Advisory: Responsible Party for Personnel Costs? Amount: Invoice # Forwarded to: Date: Rev.1/26/16.Business Office/Facilities/cmc
3 Merritt College 12500 Campus Drive Oakland, CA 94619 Facilities Office: (510) 434-3967 Carmen Chavez: cell 510-304-0639 Head Custodian Tim Brice: cell 510-517-6279 Business Office Manager Dr. Dettie Del Rosario: cell 707-631-0258 Facilities Rental Needs I will take the facility AS IS. I will require a set-up. Completed Diagram for Room Set Up There will be food/catering. I will provide my own food. There will be no food at this event. Audio Visual (AV), Information Technology (IT) & Other Needs: I do not require anything. I will need AV/IT support* I request the following (Please note: some equipment is only available for certain room):. Equipment Number Available Easel & Flipchart 1 LCD Projector 2 Microphone 3 NOMAD (state of art integrated system including microphone, projector, computer, 1 projection of hard copy on screen, Internet access Document Viewer) Piano (Huey P. Newton Conference Room, Stadium) 1 Sound System (Gym, Huey P; Newton Conference Room, Stadium) 1 TV/DVD Player 2 Whiteboard 1 Chairs 300 Podium 1 Tables (6-Foot) 45 Overhead Projector 1 Would you like to invite Merritt College students or the public to your event? YES NO Would you like to speak with Merritt College Public Relations or Public Information? YES NO Please Indicate Number requested Please read and initial each statement below: *I understand there will be a minimum charge of $240 if IT/AV Tech support is needed after 4pm during any week day or on week-ends or on any day the school is closed. I understand that all events must be booked at least one month in advance, or requests might not be granted. I understand that any changes or additional requests made less than ten business days before an event, are considered last minute, and may or may not be granted, depending upon staff and equipment availability. Signature: Date: RESERVATIONS ARE NOT FINAL UNTIL ALL AUTHORIZATIONS & APPROVALS ARE RECEIVED)* This event is authorized as an official Merritt College Event: Authorization Signature: Date: (Dean of Special Programs and Grants, Director of Student Activities, VP of Student Services, Division Dean, VPI) Dept. funding Personnel Costs: Amount Approved: $ Budget Code: Funder Signature: Date: Signature for Approval: Date: Business Manager or President Fees that apply, per item #6 of Rental Process, pg 1 of Application packet: Custodian Open fee: Custodian Close fee: AV/Tech fee: Athletic Supervisor Fee: TOTAL: Rev.1/26/16.Business Office/Facilities/cmc
Audio Visual (AV) Support Questionnaire Information Technology (IT) & Smart Classrooms *Please note that a minimum of Please check if applicable: $240 AV/IT fees may apply, refer to [ ] AV/IT support is requested; Please complete Support this form Questionnaire item #5 under Rental Process on first [ ] No AV / IT tech support is requested; Please disregard this form page of this packet for more info Requestor: Date: Event Date: Event Location: Event Set-up time: Event Start time: Event End time: Name: Event lead-who will be at the set-up with I.T. before he/she leaves. Phone: Email: In Door Events Only Room number Do you have an agenda outlining your event? Yes, provided on No Bringing own computer PC MAC **Mac bring your own VGA adapter **Bring your own presenter remote/clicker Can your presenter come an hour early to Test the IT equipment or can they come on another day? Please circle. Does I.T. need to be on standby for all or part of your event. If you only need them for part please provide detailed information. Will you be bringing Media i.e., USB, DVD, VHS, Paper, and/or transparency. Do you need the document viewer Will you be using Powerpoint (Note that MAC documents must be saved for PC or they might not work on our system) Internet links and other media (i.e, youtube) are to be provided ahead of time for testing Do you need a podium Do you need wireless microphones, handheld and/or Lapel (quantity varies by room), wired microphones (1-4) and additional speakers * 4 Out Door Events Only D-Quad: Requires an individual from the Student Club or Department to be present for briefing on equipment use. Please inform I.T. if you will need their support and representative throughout the event. Will Music support be required Sound board PA System Number of wired microphones only 1 3 RCA- Iphone/Laptop cable Equipment ONLY Projector Laptop Extension Cord Are there any other factors that you think I.T. staff should know about to better support your event?
Do you need the student lounge to be set up for you? Please circle one: Yes. No. If yes, Please use this form to illustrate how you want the student lounge set up for your event. If no, please disregard this form.