Application Date: Event Date:
                                                 Sun Mon Tue Wed Thu Fri Sat
Sponsor/Organization
(If your organization goes by an acronym (initials), indicate full name of organization)
Contact: Work Phone:
Cell Phone: FAX: Home Phone:
E-mail:
Address: State Zip:
Alternate Contact: Phone:
Event Description:


Type of Event: Employee Activity Press Conference Public Activity/Rally
Display (Indicate size and number of pieces)
Other(Describes)
Building:
Space Requested:
Expected Attendance: < 25 26-100 101-500 501-1000 >1001
(Time) From: To:
Equipment you will be using:
Noise that would disrupt the normal business of office employees and visitors to the Capitol Complex
is not permitted. Effective July 1, 2008 - the Iowa State Capitol Complex is a Tobacco and Smoke Free Environment.

Iowa Department of Administrative Services
Attn: Nancy Williams, Events Coordinator
Hoover State Office Building, A Level
Des Moines IA 50319
Phone: 515-281-7259
Fax: 515-242-5974
E-mail: nancy.williams@iowa.gov