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SMC Preliminary Community Facility Request Form

THIS IS JUST A PRELIMINARY FORM. AT THE POINT OF SUBMISSION OF THIS FORM, FACILITIES HAVE NOT BEEN RESERVED FOR YOUR EVENT. Once your request has been reviewed and a room assignment can be confirmed, you will be notified of the finalized details of your reservation via the email address you provide below.

Contact Information
Event Information
See Event Promotion section below for additional details on where the text you enter here may be used.
Event Timeline

When scheduling your event, please adjust your start and end times to allow time before your event for setup and after the event concludes for cleanup if needed.

If you do not include setup and cleanup times in the timeline for your event, you can expect that the room(s) you reserve will only be accessible approximately 10 minutes prior to Start Time indicated below and will close at the End Time indicated for your event.

Reservations will not be accepted more than 6 months in advance of an event.

Please include any other details pertaining to the scheduling of your event as needed in the space provided above.
Preferred Event Location
If you are familiar with our facilities and have a building and/or room in mind for your event, please indicate your preferences below. If you would like us to provide assistance in building/room selection for your event, please select Unknown-Other for Building and complete the Room Attributes section of this form to provide specific details on the type of facilities you will require for your event.
Check all that apply. For items not listed above, select Other and describe your needs in the space provided.
Please describe in detail the attributes needed for your reservation.
Electronic Equipment Requirements

Please check off any audio, visual or computer equipment you will need for your event. In addition, you may select Other to describe any additional needs in the space provided below.

Please describe any additional electronic equipment that you need for your event in the space provided above.
Room Layout Instructions
If you select no, we will assume that you do not want any changes to the layout of the room you are requesting for your event and that you will be using the room AS IT IS CURRENTLY SETUP.
Please include any special instructions or information in the space provided above.

Use the Browse button, to select your file from your local computer system; once selected click Upload button. A link to your Room Layout Drawing will be included with your form submission.

Files must be less than 2 MB.
Allowed file types: gif jpg png pdf doc docx.
Liability Insurance

Southwestern Michigan College requires that any organization who uses our facilities have liability insurance in effect during the time frame of this event. SMC must receive proof of this insurance coverage prior to your event.

You have indicated that you are unable to upload proof of your liability insurance at this time. Please provide this information via one of the following methods prior to your event:

  1. U.S. Mail: Send a copy of your proof of insurance to Southwestern Michigan College, Buildings and Grounds Department, 58900 Cherry Grove Road, Dowagiac, Michigan 49047;
  2. Facsimile: Send your proof of insurance via facsimile to the Maintenance Department at Southwestern Michigan College at 269-782-1394; or
  3. Email: Email proof of insurance to Andrea Wall, Administrative Assistant for Buildings and Grounds at Southwestern Michigan College at

Use the Browse button, to select your file from your local computer system; once selected click Upload button. A link to your proof of insurance will be included with your form submission.

Please upload a copy of your liability insurance.
Files must be less than 2 MB.
Allowed file types: gif jpg png txt pdf doc docx.
General Comments/Questions
Please enter any additional questions or comments in the space provided above.
Use of Facilities Policy Acknowledgement

The submitter of this form (who is 18 years of age or older) acknowledges or organization agrees to be responsible for the use of the premises, including the actions of those in attendance at the event. The submitter and/or the organization agree to indemnify and hold harmless Southwestern Michigan College, its officers, agents and employees against all claims, demands or causes of action against them for property damage and/or personal injury arising out of the use of the College facilities by the undersigned even if such claims, damages or causes of action allege negligence or other fault on the part of the College, its officers, agents or employees. Further, the submitter agrees to indemnify the College for any damage to College property arising out of the use of the College facilities by the submitter or organization.

By inserting my signature in the space provided below, I acknowledge that I have read Southwestern Michigan College's Use of Facilities Policy and agree that the use of said facilities will be in accordance with the terms and conditions outlined in this policy.

You may add your signature by using either a mouse on a computer or your finger/stylus on a touch device.