UC Merced Conference Services
Housing Conference Services, University of California, Merced
5200 North Lake Road, Merced, CA 95343
T: (209) 228-4663 • F: (209) 228-7640 • E: housing@ucmerced.edu
http://housing.ucmerced.edu/conferences

APPLICATION FOR USE OF UC MERCED HOUSING FACILITIES

(Items with * are required.)
General Information
Name of Conference: *

Official Name of Sponsoring Organization: *

Address: *

Conference Organizer (CO): *

CO Title:
CO Email: *

CO Telephone:
CO Fax:
Financial Contact (FC): *

FC Title:
FC Email: *

FC Telephone:
FC Fax:
On-Site Contact Name (SC): *

SC Email: *

SC Telephone:
SC Fax:
Names & Titles of Key Officers and/or Directors of Official Sponsoring Organization:
Purpose of Official Sponsoring Organization: *

Do you have a UC Merced sponsor?

If yes, Department Contact (DC):
DC Telephone:
Purpose of this Conference (please attach past or present program brochures or any printed material) *

Upload any electronic versions of organizational material:
(Only Word, Excel, PDF, Image, And Text Files Are Allowed)
(Please Upload File With No More Than 2 MB Size)
Is Official Sponsoring Organization a Non-Profit Organization?

Source of financial support for the conference:
Does your Organization have any political and/or religious affiliation?

If yes, please describe:
Is your group primarily:

Number of participants/staff:
Commuters:
Arrival / Departure Information
Conference Date/Time (preferred) Arrival: *

Conference Date/Time (preferred) Departure: *

Will you have participants arriving before the conference start date?

Will you have participants departing after the conference end date?

Housing Request
Total number of participants to be housed: *

Total number of singles (one person per room):
Total number of doubles (two persons per room):
Will you have any special accessibility needs?

Are there any participants under the age of 18?

If yes, how many:
Desired Linen Service
Student/Youth (No linens or amenities):
Standard (Linens provided in bedroom, beds not made):
Premier (Beds made, fresh towels daily):
Dining / Catering Needs
All dining and catering needs can be arranged through Lakeside Catering at catering@ucmerced.edu or by calling (209) 228-2287.
Meeting Rooms
Meeting Room Requirements (please specify Type: theater style, banquet seating, classroom style with tables, reception seating; Conference styles: U-shaped, E-shaped, T-shaped, Board Table, Hollow Square; Audio Visual Equipment; Capacity and Time of Day needed):
Other Conference Needs
Will you require the use of a Computer Lab?

Recreational game tables?

An on-site office during program dates?

Mail service?
(only available for long stays in housing)

Other special requirements:
REFERENCES: Please list other locations where your group has sponsored a conference:
(Include Location, Person to Contact, Telephone, Dates)
Your Name: *

Your Title:
I have read and agree to the UC Merced Housing General Policy Guidelines attached to this form. *



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