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DANIELS LEADERSHIP CENTER
REGISTRATION APPLICATION

The following form forwards information to the Daniels Leadership Center Staff in order to reserve your event at the Daniels Leadership Center.

It does not guarantee the availability of the date and time/s you are requesting. The manager will contact you to confirm the date and time/s once the form is submitted.

If you have any questions about this form please feel free to contact us.

 


 

Your Organization's Name

Primary Contact and Title

Name on Contract:

Address

City State Zip

Organization's Phone Organization's Fax Number

Organization's Email

Estimated Date (if unknown please give range of dates)

Estimated Total Attendance During Event/s

Estimated Time of Arrival Estimated Time of Departure

Which Rooms are you Requesting?

 

200B- Engagement Auditorium

- Simulation/Re-enactment Stage

DLC_200B
- Jack Daniels Room DLC_300
118A - Classroom A DLC_118A
118B - Classroom B
118C - Classroom C DLC_118C
114 - Computer Lab DLC_CompLab
Library DLC_Library

 

Audio / Visual Accomodations

Laptops Number Projector
Rooms Wireless Mouse Number Internet Connectivity Number MicrophoneNumber Smart Board Number EaselNumber
Other:

Beverage or Food Accomodations (at additional costs)

 

Drink Coffee
Water
Soda
Other:
Drink Comment / Recommendation
Breakfast Continental
Full Breakfast
Other:
Breakfast Comment / Recommendation
Lunch   Lunch Comment / Recommendation
Dinner   Dinner Comment / Recommendation
Snack Tray   Snack Comment / Recommendation
Catering Kitchen
Comment / Recommendation

 

Please Indicate Any Experiential Activities Requested (at additional cost)
High Ropes Low Ropes Cooperative Games Leadership Reaction Course

Would you like a Tour of NMMI? Yes No

 


 

Method of Payment Check Other

INSTRUCTIONS: Submit this form electronically, or print and mail or fax it to:

Daniels Leadership Center
New Mexico Military Institute
101 W College Blvd
Roswell, NM 88201

Fax: (575) 624-8318

Phone: (575) 624-8148

Campus Map and Travel Directions if needed

Any Other Comments: