Loker Student Union | Event Planner Form

Organization/Type *

Cultural & Identity Centers
Auxiliary
Campus Department
Student Club/Organization
Off Campus

Organization Name *

Contact Name *

Pronouns

Primary Email *

Alternate Email

Phone Number *

Best Way to Contact *

Address *

Address Line 1

City

State

Zip Code

Title of Event *

List of Event Days *

From This Date

To This Date

Recurrence Pattern

Daily
Weekly
Monthly
None

Access Start Time *

Access End Time *

Event Start Time *

*If multiple event times, please list them in the description below.

Event End Time *

Estimated on Campus Attendees *

Estimated off Campus Attendees *

Detailed Description of Program (Add an additional sheet, as needed): *

Upload Additional Files

Click or drag files to this area to upload. You can upload up to 4 files.

Event Information

Please check YES or NO to the following statements regarding event details: (Additional fees may apply)

1. Will food be served by Campus Catering? *

Yes - by Campus Catering
Yes - by Private Caterer (Fill out Exception for Campus Catering)
No

If yes, who is providing? *

Exception for Campus Catering Form (For on campus entities only)

2. Will Alcohol be served? *

Yes - If so, must order through Campus Catering.
No

3. Are registration, admission fees or donations being accepted? *

Yes
No

If yes, please specify amount: *

4. Is this event a profit-making venture (product showing, solicitation of goods or services)? *

Yes
No

5. Will this event be sponsored or promoted by a non-University or off campus organization? *

Yes
No

If yes, specify: *

6. Is this event co-sponsored by the LSU or on campus department? *

Yes
No

If yes, specify: *

7. Does this event directly relate to the educational mission of the University? *

Yes
No
Not applicable - Private Event

8. Will there be a vendor fair or exhibitors as a part of this event? *

Yes
No

If yes, please specify no. of vendors/exhibitors: *

9. Will there be a guest speaker? *

Yes
No

If yes, please specify full name: *

10. Will media (DH Bulletin or news outlets) be notified about this event? *

Yes
No

If yes, please specify media outlets: *

11. Will filming occur during this event? *

Yes
No

If yes, please specify filming supervisor: *

12. Will this event include a film screening? *

Yes - If so, viewing rights must be provided before event can be confirmed.
No

13. Is this a dance, concert or casino night? *

Yes
No

14. Will this event include amplified sound? *

Yes
No

15. Will your event have decorations? *

Yes
No

If yes, please describe the decor: *

16. Will your event have banners & signage? *

Yes
No

If yes, please specify the quantity & sizing of each: *

17. Are you able to produce a Certificate of Liability Insurance (COLI)? *

Yes - If required, sponsor must name The California State University, Dominguez Hills, Donald P. and Katherine B. Loker Student Union Inc., its Board of Directors, officers, members, employees and agents, the California State University, Dominguez Hills, the State of California, the California State University Board of Trustees, and all of its other departments, boards, and commissions and its officers, employees and agents, are hereby declared to be the additional insured. The general liability limit must be of no less than one million dollars ($1,000,000).
No

Event Spaces

Please check all that apply.

Please view the Set-Up Styles we offer. If you do not see your desired set up, we can help you create a diagram for your event.

Ballroom Spaces

Ballroom A