Samford University

2015 Summer Camp & Conference Date Request Form

Please use this form to request your summer 2015 dates at Samford University. Note: This form does not serve as a final confirmation or an official reservation of space. The purpose of this form is to request available dates for the Summer of 2015 and to provide estimated numbers to support the request. 

All requests must be submitted on or before Monday, December 9, 2014 after which time this registration form will close. 


Name of Camp / Conference  

Contact Name      Contact Phone        

 Contact Email 

Organization Name 

 Organization Billing Address    

Organization Website 

If your organization is a non profit with 501(c)(3) status, please provide your EIN 

If no EIN is provided it is assumed this is a for profit organization.


Sponsorship - Choose One

This is an internal event sponsored by an official Samford organization, academic or athletic department. 

              -If box above is checked, please provide the department index code 

This is an external event not sponsored by an official Samford organization, academic, or athletic department.

Dates  - Please list your top 3 choices for camp beginning and ending dates

1st Choice Camp Dates:  through  

2nd Choice Camp Dates:  through  

3rd Choice Camp Dates:  through  



Estimated Number of Persons Attending 

 Staff:     +    Campers/ Conference Attendees:  = Total Estimate of Attendees 

Estimated Number of Residence Hall Rooms needed for overnight stays (Each room accommodates 2 guests) 

Age Range of Campers: Lowest Age  to Highest Age 

Estimated Number of Cafeteria Meals (per person):

Breakfast:    Lunch:   Dinner: 

First Meal     

Last Meal