Request for Department Administrative Event Support Instructions: Please complete this form with as much information as you can so we can effectively assess your request. If you anticipate needing support for certain planning processes listed in this form but do not yet have the details, please check “yes” and fill in as much information as you are able. If you provide a response that denotes “does not apply,” support will not be given in that field. Please note: Submission of this form does not guarantee that you will receive any or all of the requested support. Support will vary based on the time available to plan and complete the requested tasks, as well as the previously agreed-upon support from the Department Chair. Forms submitted well in advance of the date of the event are more likely to receive support. For official Business Services Policies about events, please see this website. When scheduling an event date, please refer to the Department of History events calendar and the UW-Madison events calendar COVID-19: Please keep in mind that due to the ongoing COVID-19 pandemic, event policies at the UW-Madison are constantly subject to change. Organizers should consult the UW-Madison COVID-19 Response webpage for the most up-to-date events policy. Hybrid Events: The Department of History is currently limited in providing hybrid event and meeting options in our departmentally controlled spaces. The Curti Lounge is not capable of supporting hybrid events or meetings at this time. If you would like to plan a hybrid event or meeting, you will first need to consult with the History Department Events Admin Team before submitting your request. Feeling overwhelmed or confused about filling out this form? Schedule a meeting with the History Department Events Admin Team. Event Organizer Expectation* In submitting this form I acknowledge that I am the main event organizer and understand that I am responsible for all administrative planning, pre-event coordination & post-event clean up, and financial tracking responsibilities related to my event.Sponsorship* I understand that in the event that my requested administrative support is approved, the History Department will be acknowledged as an event sponsor on publicity materials for my event.COVID-19* I understand that I have reviewed the most up-to-date COVID-19 event policy information, and that my event request falls within UW-Madison policy. I also acknowledge that, should event policies change, I will be responsible for making alternative arrangements for my event.General Information: All applicants must complete this section.Name* Title or Purpose of Events* How does the business purpose of this event fit into the mission of the University of Wisconsin-Madison?**If unfamiliar, read the Mission of the University of Wisconsin-Madison.Date(s) of Event:* Time Event Begins and Ends:* Location of Event* Who will be invited to your event? Please select all that apply. (Spouses/family members of invited guests and faculty/students are not allowed without prior approval from the University).* Select All Faculty Students Public Alumni Other (please explain below) Other Please list your sources of funding and describe the overall budget for your event:(Click the plus sign after first entry to add an additional source)List*SponsorAmountDesignated ExpenseFunding Contact Total Budget:* What other unit on campus is assisting with your event planning (if applicable)?* Virtual EventsDo you require assistance setting up a virtual platform for your event?* Yes No, I will be setting up the virtual platform myself. Does not apply because virtual platform is unnecessary. Does not apply because another unit on campus is coordinating the virtual platform arrangements. Please specify which platform you desire to use:* Option A: Zoom Option B: Webex Option C: I would like to have a staff member consult with me on which platform would be best for my event. Who will moderate the session(s)? This cannot be a staff member.* Who will serve as a backup moderator in the event that your internet connection is faulty? This cannot be a staff member.* Please list the names of any panelists in addition to the presenter and the moderator here.*Would you like a recording of the session(s) to be made?* Yes No How many attendees do you anticipate hosting virtually? Please note that events with more than 300 people will require obtaining a special Zoom license from DoIT.* Do you plan on holding a Q&A during the virtual event?* Yes No AirfareAre you requesting support in organizing airfare for your event?* Yes Does not apply because airfare is unnecessary. Does not apply because another unit on campus is coordinating the airfare arrangements. How many travelers will need airfare? What is your maximum per traveler budget for each ticket? When required, will you be covering ground transportation costs for travelers? Please provide the email address where you would like purchased ticket confirmations to be sent: Funding source/string (if different than above): LodgingAre you requesting support in organizing lodging for your event?* Yes Does not apply because lodging is unnecessary. Does not apply because another unit on campus is coordinating the lodging arrangements. How many travelers will need lodging? If all costs are the same, which downtown Madison hotels do you prefer? Who will be the main contact for the traveler while they are in town? Traveler full name(s) (as it appears on official travel documents): Traveler Email Address(es): How many nights would you like the guest(s) to stay? Funding source/string (if different than above): Honorarium/Travel IncidentalsAre you requesting support in administering honorariums or travel incidentals for your event?*For detailed information about required tax forms, click here Yes Does not apply because honorarium/travel incidentals will not be provided. Does not apply because another unit on campus is coordinating the honorarium/travel incidentals. Name(s):* Honorarium amount(s): Reason for honorarium(s) (services rendered):* Funding source/string (if different than above): Will you cover travel incidentals? ***If both honorarium and travel incidentals are requested, the travel incidentals will be included in the honorarium. If only travel incidentals are requested, the traveler must do a reimbursement.* Yes No Are they a UW system employee? If yes, additional information will be required.* Yes No Space ReservationAre you requesting support in reserving a space for your event? Please note that all contracts with non-University vendors will need to be signed by campus purchasing. Non-University vendors include, but are not limited to, the University Club and Fluno Center.* Yes Does not apply because a space reservation is unnecessary. Does not apply because another unit on campus is coordinating the space reservation Please list the date(s) as well as the desired start and end times:* Will your event require multiple venues? If so, please describe.*Do you have any desired location(s) in mind? If so, please describe here:Please note the following: *** Listing a desired location is not a guarantee that the space will be able for your event. *** All events scheduled in the History Department Curti Lounge must adhere to the microphone policy (pdf). *** All event organizers should make every attempt to create event spaces that are as accessible and welcoming to all persons. See Planning an Accessible Event. Please estimate the attendance for your event, or list a desired seat capacity for the room in which the event will take place:* What kind of tech equipment will the speaker require? Check all that apply. Projector and screen Laptop Microphones (hand-held, lapel, or table) None Other (please explain below) Other: Are you requesting on-site tech support for the day of the event?* Yes No What type of room setup will you require (lecture-style seating, tables, podium, etc.)?* Who will review the final event plans and logistics with the venue coordinator?* Food/Refreshment ArrangementsAre you requesting support in arranging for food or refreshments to be served at your event?*Please note that all contracts with non-University vendors will need to be signed by campus purchasing. Non-University vendors include, but are not limited to, the University Club and Fluno Center. Yes Does not apply because food/refreshments are unnecessary. Does not apply because another unit on campus is coordinating the food/refreshments. Please describe the type of food or refreshment that you would like to serve at your event: Who will be deciding the final menu and coordinating selections with the caterer?* How much would you like to spend on food in total?* Do you have any preferred caterers?* Who will pick-up the catering or meet the caterers at the event?* Do you plan to host your guest for a business meal?*If so, you will need to adhere to these University policies: 1. Itemized receipt required for reimbursement 2. Sales tax not allowed 3. Without Foundation funding, meals are limited to the University meal maximums, and alcohol is not allowed Yes No PublicityAre you requesting support in creating publicity materials and/or advertising your event?* Yes, creating publicity materials and advertising Yes, advertising Does not apply because publicity is unnecessary. Does not apply because another unit on campus is coordinating the publicity. Please note that if the Department of History staff are providing event support, the History Department must be acknowledged as a sponsor on the event poster. Contact Brie Oremus (email@example.com) for logo images. Event Title: Speaker Name: Speaker’s Position or Professional Affiliation: Event Description or Speaker Bio (if applicable):Event Dates: Event Time (if known): Event Location (if known): List all event sponsors that should be included on the poster. Please note that if the Department of History staff are providing event support, the History Department must be acknowledged as a sponsor on the event poster: Please upload any logos for the event sponsors that should be included on the poster: Drop files here or Select files Max. file size: 24 MB. Please upload any images that could be included on the poster: Drop files here or Select files Max. file size: 24 MB. If available, please upload a copy of the event poster and photo of speaker(s). Drop files here or Select files Max. file size: 24 MB. If you are looking to have your event advertised by the History Department, please indicate the platforms that would be appropriate for your event. Check all that apply. Social Media (Facebook, Twitter, Instagram) History Events Newsletter (distributed weekly via email) Website (events calendar) Ordering SuppliesAre you requesting special supplies (non-food related) to be ordered or purchased for your event?* Yes Does not apply because ordering supplies is unnecessary. Does not apply because another unit on campus is ordering supplies. Please describe here the supplies that will need to be purchased for your event:* Student Hourly AssistanceAre you considering hiring a student hourly to help assist with your event?*Please note that students are limited in their capabilities to process certain parts of an event Yes Does not apply because student hourly assistance is unnecessary. Does not apply because another unit on campus is coordinating student hourly assistance. Name:* Start Date:* MM slash DD slash YYYY Rate of pay ($15/hr max):* Funding Source (if different than above): Expected Duties:* OtherAre you requesting any other support for your event that has not been covered by the categories above?* Yes No Please describe here:*Consent* I understand my information is being used for Department Event Support purpose(s).