(
*
indicates a required field.)
*
1).
First Name
*
2).
Last Name
*
3).
Email Address
*
4).
Phone Number 1
5). Phone Number 2
6). Fax Number
*
7). Department
*
8). What room or area would you like to reserve?
Classroom
Conference Room
Computer Lab
*
9). What is the name of your event?
*
10). Briefly describe the purpose of your event
*
11). Will the attendees be faculty, staff or students?
*
12). Please indicate the month, day and year you need to reserve the facility
*
13). What time will your event begin?
*
14). What time will your event end?
*
15). If you are reserving a room, will you need to be in the room more than 15 minutes before or after the event?
Yes
No
*
16). How many people will be attending this event?
17). Special requests regarding room set up:
*
18). Will there be refreshments served? Will lunch be served?
Yes(refreshments)
No(refreshments)
Yes(lunch)
No(lunch)
*
19). Is the event being catered?
Yes
No
20). Technology requirements (conference phone, projector, etc.)