USC Suzanne Dworak-Peck School of Social Work Event Response From

Event Request Form

Suzanne Dworak-Peck School of Social Work

Advanced Notice & Event Lead Time:

Key events (e.g., commencement celebrations, annual events) and events with 100 or more attendees must be submitted to the Social Work Special Events Office 9 - 12 months in advance of the event date.
Events with under 100 attendees and those which require less logistical assistance must be submitted to the Social Work Special Events Office at least 3 months in advance of the event date.

Please complete the information requested below in order to provide the Social Work Special Events Office with details and requirements necessary to plan and support your event. These details will ensure you receive suitable event recommendations within your designated budget.

Event Organizer Information (This person is responsible for identifying the budget, event/program agenda, speakers, guest list, event planning, etc.)

Event Organizer Name

Event Organizer Email

Event Organizer Phone Number

Department

Lead Contact Information (Person completing this form, if different than Event Organizer.)

Lead Contact Name

Work Phone Number

Cell Phone Number

Email Address

Department

Budget: This form should be submitted with a proposed budget.

Budget Amount

Approved Budget? (Yes/No)

PPPG (account #)

Event Details: Note-USC requires permits, rentals, and diagrams for outdoor event spaces/locations that incur extra fees.

Event Name

Date of Event (1st preference)

Date of Event (2nd preference)

Venue/Location

Time of Event

Set-Up Time

Break Down

Annual Event (Yes/No)

Revenue Generating (Yes/No)

Is there a speaker present? (Yes/No)

Is this person confirmed? (Yes/No)

Event details/Purpose:

Estimated Number of Attendees:

Agenda/Program: Provide all information; e.g., registration time, presentation time, dinner time.

Reception/Registration

Presentation/Speaker

Dinner

Conclusion

Team members working the event: Pre-event planning and day-of event.

Name and responsibilities: (e.g., John Doe, PowerPoint presentation, registration/check-in & printing name badges)

Team Member 1

Team Member 2

Team Member 3

Team Member 4

Team Member 5

Team Member 6

Select format: What type of event will this be?

Event Layout: Select all that apply.
Please include quantities required.

Rounds (Example: 8 rounds of 10)
U-shape
Hollow Square
Board Table
Cocktail Tables
Theater Style
Classroom Style
Other

Special Needs: We are committed to ensuring that all individuals who attend any event may do so in a manner that is respectful of their individual needs.
Individuals with disabilities who need accommodations to attend this event may contact Elizabeth Gutierrez, 213-740-5994, elizabeth.g@usc.edu. It is requested that individuals requiring accommodations or auxiliary aids such as sign language interpreters and alternative format materials notify us at least seven days prior to the event. Every reasonable effort will be made to provide reasonable accommodations in an effective and timely manner. Please let us know if your accommodation request is for you or your guest(s) and include any additional information below.