SACRED SPACE REQUEST FORM

Center for Spirituality, Dialogue, and Service • Office 203 Ell Hall •csds@neu.edu

•(617)-373-2728 •fax (617)-373-8486

Purpose of Use

Description of Use: *

Name of group: *

Est. size of group: *

Check one: *

NU students

NU staff or class

NU alumna

Non-NU

Date & Time

*

1-time use:

Weekly use:

Month/date/year * +

Day of Week (Monday, Tuesday etc...) *

Please fill out for weekly use: Start date

End date

Event Start Time *

Event Ending Time *

Full Booking time: from *

until *

(Include time for set-up & clean-up in your “full booking time” request.)

Area/s Requested

Area/s Requested *

Sacred Space (Capacity 120)

Reflection Room (Capacity 10 at table, 15 chair circle, 40 standing)

Note that food is not permitted in the Sacred Space. For receptions, also request the Reflection Room.

Resource Need

Resource Need (check all that apply)

Chairs

How many? *

Meditation cushions

How many? *

Yoga Mats

How many? *

Table/alter

Lectern/pulpit

We wish to serve good/drinks

Other Other

Additional Details on Resource Needs Additional Details on Resource Needs

Your Contact Information

First Name *

Last Name *

Phone Number *

Email Address (please list your Northeastern Email) *

Street Address *

Address Line 2

City *

State *

Zip Code *

Terms and conditions of use

I understand that
1- Fire code prohibits use of candles, incense etc. (religious needs may be discussed w/ the Director of The Center for Spirituality, Dialogue, and Service );
2- I am responsible for leaving the requested areas clean and in the way I found them;
3- Funds/money may not be collected in the areas except when given express permission by the Director of The Center for Spirituality, Dialogue, and Service;
4- This request is not confirmed until I receive written notification from The Center for Spirituality, Dialogue, and Service (allow two weeks);
5- The Center for Spirituality, Dialogue, and Service reserves the right, in rare instances, to reschedule or cancel an event; and
6- The Center for Spirituality, Dialogue, and Service reserves the right to refuse future use, should the conditions above not be adhered to.” *

YES

Please share any additional relevant information or concerns in the space below.