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EVENT ROOM SCHEDULING FORM

A red asterisk ( * ) indicates a required field.

Event Details:

* Reservation made by:

* Department:

* Email:

* Telephone number:

( )

* Date of Event (mm/dd/yyyy):

Through

* Event Start Time:

(hh:mm)

* Event End Time:

(hh:mm)

* Number Attending:

Please select a preferred room:

Training Room 103 Room Details Room 103	East Conference Room 304 Room Details Room 304	West Conference Room 305 Room Details Room 305
	East & West Conference Room 304 - 305 Room Details BOTH room 304 and 305
Educational Support Services schedules the Shore Family Forum (seats 100) and Conference Rooms 202 / 204 (seats 10 / 30 respectively). Please contact ESS for more information or to schedule these rooms.

* Please check only the Audio and Video items you will need:

No Audio or Video items needed
Data projector
Projection screen
Podium
Audio conferencing
Cameras
Videoconferencing capability
Wireless Internet connection
35 mm Slide projector
Document camera
Other:

* Food and Beverages (only non-alcoholic beverages are permitted):

None
Beverages
Food and Beverages

* Please choose affiliation (check only one):

NCNHB Occupant
UCDHSC
UCH
State of Colorado
Community
Other :

* Briefly describe event in box below (please note that no wet lab activities are permitted):