1. Club Name:
2. Contact Person:
3. Contact Phone:
4. Contact E-mail:
5. The club intends to use Rice Recreation space for practices and/or games:  Yes  No
   

If yes, please fill out the following section:

1. Requested day(s): (Please check all that apply)

   Monday Tuesday Wednesday Thursday

   Friday Saturday Sunday

2. Requested time(s):
   (Please be as specific as possible, e.g. Monday: 5-7 p.m.; Tuesday: 6-8 p.m.)

There is the possibility that the requested day(s) and/or time(s) above will not be available. Please fill out the following section in the event that your primary requested day(s) and time(s) are unavailable.

1. Alternate day(s): (Please check all that apply)

   Monday Tuesday Wednesday Thursday

   Friday Saturday Sunday

2. Alternate time(s):
   (Please be as specific as possible, e.g. Monday: 5-7 p.m.; Tuesday: 6-8 p.m.)
3.