Pierce College Puyallup Student Life

Table Request Form

This is for off campus, campus organizations, or student initiatives.

Date: Requested By: _____

Are you a: Pierce College Student Non Student

Sponsoring Individual/Organization:

Contact Information: _____________________________________

Activity, Issue, or Initiative Name: ___________________________________

________________________________________________________________

Table Request (#) _____ Wifi needed? Yes___ No____

Date Requested: Duration:

Activity Description (gathering information, disseminating information, etc…):

_________________________________________________________________
_________________________________________________________________
_________________________________________________________________

The signature below verifies that I will abide and follow the Off Campus Vendor or Organization
procedures. I understand that if I fail to abide by the procedures that it may result in facility use
being revoked.

____________________________________ _____________________
Requestor Date

____________________________________ _____________________
Director of Student Support Services & Student Life Date

Updated 7.10