Facility Reservation Request Form

Section 1: Requestor/Meeting Coordinator Information
Name*

First NameLast Name
Department/Organization*
Phone Number*

Area CodePhone Number
Email*
example@example.com
Section 2: Event/Activity Details
Title of Event/Activity*
Purpose of Event/Activity*
Estimated Number of Attendees*
Target Audience*
e.g., employees, trainees
Type of Activity*
e.g., seminar, training, workshop
Section 3: Date and Time
Preferred Date(s)*
Alternate Date(s)*
Start time*

:HourMinutesAM/PM Option
End time*

:HourMinutesAM/PM Option
Section 4: Facility and Equipment Needs
Room(s) Requested*

Main training roomOther
Equipment Requested

TV with HDMI cordInternet AccessOther
Note: Users are responsible for setup and use of all equipment.
Section 5: Table Setup Configuration
Indicate Configuration*

Classroom style: Rows of tables with chairs facing the frontU-shape style: Tables in a "U" with chairs aroundBoardroom style: One large table with chairsTheater style: Chairs only, no tablesOther
Custom Configuration Diagram

Browse Files

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Section 6: Acknowledgement and Agreement
Meeting Coordinator/Requestor Name*
I have read and agree to all terms and conditions on the coordinator checklist*

Yes, I have read the items and I agree with all of them
Read terms and conditions on the meeting coordinator checklist
Signature*

Clear
Date*

MonthDayYear
Date
Please verify that you are human*
Should be Empty: