Internal Room Reservation Form | Florida SouthWestern State College

Event Name *

Description of Event *

Event Type

Is this related to an academic course? If yes, indicate course CRN:

Requestor Information

Organization (Department) *

Requestor's Name *

Email Address *

Telephone Number

Are you reserving this space on behalf of an external organization?

Yes No

If yes, organization name:

Event Date & Time

Event Date *

Start Time *

End Time *

Setup time needed

Takedown Time Needed

Does this event repeat?

Yes No

If yes, please list dates or meeting pattern:

Location

Campus *

Preferred Room

Estimated Attendance *

Is a polycom video connection required?

Yes No

If so, which campuses will connect?
Charlotte | Preferred Room: Est. Attendance:
Collier | Preferred Room: Est. Attendance:
Hendry/Glades | Preferred Room: Est. Attendance:
Lee | Preferred Room: Est. Attendance:

Resources

Please describe any setup requirements, such as table arrangement, security, etc...

Please describe any audiovisual needs, such as setting up for presentation, sound system, etc...

Food/Beverage to be served? *

Yes No