CMUBS Group Application for Use

Institution/Organization and Lab Name (if applicable)

Primary Contact Person's Name (First and Last)

CMU ID Number (if applicable)

Phone

Email

Billing Street Address

Billing City

State

Billing Zip Code

Tax exempt number (if applicable)

Please describe the purpose of your visit

Arrival Date

Arrival Time

Arrival transportation/mode (BIBCO Ferry, Island Air, Fresh Air)

Departure Date

Departure Time

Departure transportation/mode (BIBCO Ferry, Island Air, Fresh Air)

Number of guests

Number of minors

Guest names, dietary restrictions/preferences (this is required two weeks in advance)

Please explain any special housing arrangements needed (i.e., adults in one cabin, students in the other, etc.)

Will your group need field trip lunches? (Yes/No and dates)

Would you like to rent CMU 12-passenger vans for $1.35/mile? (Yes/No, number of vans)

Would you like to rent CMU trucks for $1.35/mile? (Yes/No, number of trucks)

Names of drivers if renting CMU vehicles (Drivers will need to be approved to drive through CMU Risk Management)

Please describe the type of boat(s) needed and the purpose of the work (e.g., kayaks, canoe, john boat, 10' Zodiac, 18' Zodiac, M/V Chippewa

Field or Lab equipment needed:

Additional Notes: