Mobile Go Center Request Form

Requestor Information

PLEASE NOTE: IF YOU DO NOT RECEIVE CONFIRMATION WITHIN 24 HOURS, PLEASE

CONTACT:

Audrey Frizzell
Student Recruitment Office Administrative Assistant
512-223-7712
afrizzel@austincc.edu

There is a 72 hour advance notice required for all activities.

First Name :

Last Name :

Organization :

Email :

Phone :

Emergency Contact First Name:

Last Name:

Phone : (Please provide a mobile number if possible)

Event Type
Financial Aid
Career Planning
Admissions and Records
Other

Date and Time Information
Specify Start Date and Time

Specify End Date and Time

Location Information
Specify Location:

Address:

City:

Zip Code:

Additional Information
Comments: