COVID MITIGATION ACTIVITY/EVENT REQUEST

COVID MITIGATION ACTIVITY/EVENT REQUEST

Complete the following with detailed information so that the Mitigation Committee can make an informed decision regarding the request.

The request must be approved by the appropriate dean or administrator before being submitted.

Please submit requests at least three weeks prior to the event.

Event Information

Event Title

Is this a CCAC sponsored event?

Yes No

Has this event been approved by your supervisor? *

Yes No

STOP AT THIS POINT IF APPROVAL HAS NOT
BEEN RECEIVED

Date/Time*

Location/Room Number

CCAC Contact Information

First Name

Last Name

Number of Attendees

Are there any external attendees?

Yes No

Number*

Event Summary:

Will travel be involved?

Yes No

Please provide the details of the transportation.

Will refreshments be included in the event?

Yes No

If yes, please describe in detail the refreshment distribution process and location.

Provide details about CCAC COVID mitigation protocols during the activity.

I would like to discuss the request with a member of the Mitigation Committee prior to the committee review.

Yes

Do you have any supporting documents that you would like to submit?

Yes No

Supporting Documents *

No File Chosen

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