"*" indicates required fields Student Organization*Student's Name* First Last Student's TitleStudent's Cell Phone*include area codeStudent's Email*Virtual Event* Yes No If a virtual event, are you the host of this meeting?YesNoIf you are not the host, please provide host name, email, and phone number.Virtual Events: Will you need access to any of the following?* Breakout Rooms Screen Sharing Polls N/A Select AllChapter Advisors Name First Last Event Name:*Event Category*FundraisingEducationalSocialEvent Description: (2-4 sentences required)*Date of Event* Event Start Time* Hours : Minutes AM PM AM/PM Event End Time* Hours : Minutes AM PM AM/PM Event Location: (include UAMS bldg/room or off-campus name & address)*Number of Attendees* >100 <100 Who will be in attendance?* UAMS COP Students UAMS COP Faculty UAMS COP Staff UAMS COP Alumni Non-COP Students Non-COP Faculty Friends & Family General Public Will any alcohol be on-property?*YesNo(COP funds may not be used in any way regarding alcohol purchases)We [the listed responsible parties] understand that if any alcohol is to be consumed at this event, UAMS requires a licensed security guard be present for every 75 attendees. Related costs and arrangements are the responsibility of the organization. Additionally, if it has been stated on this form that no alcohol will be on-property and it is found otherwise, the organization may be prohibited from future events.*YesNoDo you anticipate any local, state, and/or federal government officials or dignitaries to attend?*YesNoIf yes, please list names of attendeesHow will the event be funded?* Chapter’s Own Bank Account COP Student Activities N/A – no expenses Check all that apply. COP funding is not guaranteed until event is approved.Will you have any printed/electronic materials?*YesNoe.g. brochures, flyers, invitations, t-shirts, etc.We [the listed responsible parties] understand that all printed and electronic materials must be approved by the COP Dean's Office. If not done so, the graphic / item in question may be confiscated, and any costs associated will be the responsibility of the organization.*YesNoPlease attach a copy (pdf or similar file) of the sample fundraising item (ie, photograph of t-shirt, water bottle, etc) Drop files here or Select files Max. file size: 15 MB.
