Request Form

Request Form

Room Request Form

Name:

Department or Company Name:

Phone Number:

Fax Number:

Title of Event:

Exact Date(s) of Event:

mm/dd/yy

Start Time of Event:

End Time of Event:

Room Preferences:

Room 119 (lab capacity: 20 + instructor)

Room 120 (room capacity: 22-24)

Room 133 (lab capacity: 24 + 1)

Room 150 (lab capacity: 23 + 1)

Room 144 (room capacity: 14-16)

Room 145 (room capacity: 24-26)

Please check two rooms that you would prefer. If one is not available, the other will be chosen for you.

Additional Needs, Comments and/or Requests:

E-mail:

Address:

Purpose of Event:

Number of Attendants Expected: