Co-Sponsored Event Request Form

Co-Sponsored Event Request Form
This form is to be completed by the FCC Requestor. After submitting the form, the requestor may preliminarily enter the event in 25Live to hold the room. All co-sponsoring organizations must present to the College a certificate of liability insurance naming Frederick Community College as an additional insured in an amount deemed appropriate at the sole discretion of FCC.
- Date
  
  MonthDayYear
- Name
- Title
- Department
- Applicant Email
  example@frederick.edu
- Team
  Senior Leader e-mail address will auto-populate below.
- Email of Senior Leader
  Update address if necessary.
- Name of contact person
- Email
  example@example.com
- Title
- Name of Organization
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Event Name
- Event Frequency
- Event Information
- Building
- Room Number
- 2. Event Information
- Building
- Room Number
- 3. Event Information
- Building
- Room Number
- 4. Event Information
- Multiple Event Date 2
- Multiple Event Date 3
- Multiple Event Date 4
- Multiple Event Date 5
- Building
- Room Number
- Audience Type (check all that apply)
  
  Other
- Fee Paid to Outside Organization:
- Equipment Needs for Visual & Performing Arts Center (JBK)
  
  Other
- *JBK Rental: Please note that the total time requested for your event also includes the set-up and break-down of the stage. Set-up will not begin until your admittance time, unless other arrangements have been made with Facilities Planning facility@frederick.edu or (301) 846-2671.
- Describe the event below, or attach a file, explaining how FCC is Co-Sponsoring and involved in the event:
- File Upload
  
  Cancelof
- Describe below, or attach a file, explaining how sponsoring the event is beneficial to the college.
- File Upload
  
  Cancelof
- Co-Sponsor must provide a Certificate of Liability Insurance and agree to indemnify Frederick Community College and hold it harmless from all suits, claims and costs, including attorney fees, arising as a result of property damage, bodily, injury, illness, or death in any way connected with the co-sponsor’s use of College Facilities. You as the FCC representative must request from the co-sponsor an insurance certificate naming Frederick Community College as a certificate holder insured party for the following coverage which must be primary and noncontributory with respect to these additional insureds.
  
  Commercial General Liability Insurance with limits of not less than
  
  * General Aggregate Limit $2,000,000.00
  * Each Occurrence Limit $1,000,000.00
  
  To the fullest extent permitted by applicable law, any such policy shall include a waiver of subrogation in favor of Frederick Community College.
  
  Certificates of Liability Insurance evidencing the above required coverage shall be delivered to the College prior to the dates of the event/use of facilities. Such certificates shall also include the requirement for advance notice of reduction in the dollar amount of insurance, non-renewal, termination, cancellation, or change in coverage. Attach certificate below or email to Facility@frederick.edu
- Frederick Community College
  7932 Opossumtown Pike • Frederick, MD 21702
  301.846.2400 • frederick.edu
  
  Frederick Community College (FCC) prohibits discrimination against any person on the basis of age, ancestry, citizenship status, color, creed, ethnicity, gender identity and expression, genetic information, marital status, mental or physical disability, national origin, race, religious affiliation, sex, sexual orientation, or veteran status in its activities, admissions, educational programs, and employment. Under the ADA and Section 504, FCC makes every effort to accommodate individuals with disabilities for College-sponsored events and programs. For FCC employees needing accommodations, including interpreting, email humanresources@frederick.edu. For students and others with accommodation needs or questions, call 301-846-2408, or to request sign language interpreter services, please email interpreting@frederick.edu. Sign language interpreters will not be automatically provided for College-sponsored events without a request for services. Requests must be made at least five workdays before a scheduled event to guarantee accommodations. If your request pertains to accessible transportation for a College-sponsored trip, please submit your request at least 21 calendar days in advance. Requests made less than 21 calendar days in advance may not be able to be guaranteed.
  frederick.edu/accommodations
- Should be Empty: