Notice of Planned Assembly, Picketing, or Demonstration form

Student Union Leadership and Activities

Disclaimer: Submission of the Right to Assemble form does not constitute approval. All requests are reviewed by the appropriate campus partners, and final approval is granted by the Vice President for Student Affairs.

About this form

According to the Freedom of Expression and Assembly Student Policy and Procedures, SUNY Brockport students are guaranteed the rights of free inquiry and expression.

The information requested below is to ensure compliance with 8 NYCRR Section 535 and SUNY Rules for the Maintenance of Public Order. SUNY Brockport’s procedures are in no way an attempt to prevent or limit communication between and among faculty, staff, students and the administration at SUNY Brockport. The purpose is to protect the rights of others and maintain public order appropriate to a college or university campus community.
Submission Deadline: at least 48 hours PRIOR TO activity.
Attention Non-University and Non-Commercial organizations

Non-University and non-commercial organizations are required to apply for a revocable permit in compliance with the SUNY policy on Use of Facilities by Non-Commercial Organizations Policy or College Commercial Use Policy, as applicable. Please allow a minimum of two (2) weeks for review/approval of the revocable permit.
EVENT DETAILS
Blackout Days

The University has blacked out certain days on its calendar wherein the use of the campus and its facilities, including outdoor spaces, are reserved exclusively for campus-related activities that are at the very core of its primary educational mission. During these blackout periods, no person/group shall be allowed to use the designated public forum for free-speech purposes.

The University defines the blackout periods to include the following:
1. 1. During opening weekend for the commencement of fall and spring semester;
2. 2. During “reading” periods and examination periods, as set forth on the then-current academic calendar;
3. 3. During graduation-related activities and events, including undergraduate and graduate commencements;
4. 4. During major fall or spring campus-wide celebrations, such as concerts, Homecoming, Eagle Day, Open Houses, and Accepted Student Days;
5. 5. During such times that the University is hosting major campus events which require significant staff resources, such as NCAA and High School Sectional Sports Championships; and
6. 6. From the end of the fall examination period, when students leave campus for the winter holiday break, through a few business days after the first of the year.
Date of proposed activity: Date of proposed activity: / MM / DD YYYY
Expected attendance:
Title/Desciption of activity:
Time activity begins: Time activity begins: : HH MM AM/PM
Time activity ends: Time activity ends: : HH MM AM/PM
Nature of proposed activity: (Please describe, including names of any speakers)
Sponsoring Organization:
Proposed location(s)
Will activity be limited to this proposed location only?

Will activity be limited to this proposed location only? Yes No
* If no, please explain in detail, attaching additional sheets or a map.
Route Map

You must upload a map of your proposed route in the next field. This map must indicate:
1. 1. Start and stop points.
2. 2. Where speaking will happen.
Upload a map of your proposed route and any other attachment(s) here:
maximum 5 files whose total size may not be more than 10MB
filenames should not contain more than one period (.)
Have you submitted a Room Reservation Form and received confirmation from the Student Union, Leadership & Activities - Reservations that your location has been reserved?

Have you submitted a Room Reservation Form and received confirmation from the Student Union, Leadership & Activities - Reservations that your location has been reserved? Yes No
Will a speaker/loudspeaker system be used?

Will a speaker/loudspeaker system be used? Yes No
Describe the speaker/loudspeaker system to be used.
Will flags, banners, signage, or any visuals be used?

Will flags, banners, signage, or any visuals be used? Yes No
Describe the visuals to be used.
Communications
Will persons other than members of the SUNY Brockport community be invited to attend?

Will persons other than members of the SUNY Brockport community be invited to attend? Yes No
* If yes, please explain: Who will be invited and how the invitation will be extended, i.e. Radio, TV, indivudally, etc.:
Will the press/media be invited to attend?

Will the press/media be invited to attend? Yes No
If yes, who has been invited?
* If Yes, what is the date they were contacted?
How will this event be promoted?
Individual(s) from the organization responsible for and present at the event:
Name of person submitting form, if other than organization representative (listed below) Name of person submitting form, if other than organization representative (listed below) First Last
Name - Lead 1 Name - Lead 1 First Last
Position in the sponsoring organization - Lead 1
Email - Lead 1
Local Address - Lead 1 Local Address - Lead 1
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone - Lead 1 Phone - Lead 1 - ### - ### ####
Is Lead 1 affiliated with SUNY Brockport?

Is Lead 1 affiliated with SUNY Brockport? Yes No
Please upload your revocable permit here:
maximum 5 files whose total size may not be more than 10MB
filenames should not contain more than one period (.)
Name - Lead 2 Name - Lead 2 First Last
Lead 2 could also be an advisor or administrative assistant.
Email - Lead 2
Position in the sponsoring organization - Lead 2
Local Address - Lead 2 Local Address - Lead 2
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone - Lead 2 Phone - Lead 2 - ### - ### ####
Click on the Submit button to send your Notice for review and approval.

Notice of Planned Assembly, Picketing, or Demonstration form

About this form

Submission Deadline: at least 48 hours PRIOR TO activity.

Attention Non-University and Non-Commercial organizations

EVENT DETAILS

Blackout Days

Route Map

Communications

Individual(s) from the organization responsible for and present at the event:

Click on the Submit button to send your Notice for review and approval.