Internal Room Reservation Form

Event Name *

Description of Event *

Event Type

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

Organization (Department) *

Requestor's Name *

Email Address *

Telephone Number

If yes, organization name:

Event Date *

Start Time *

End Time *

Setup time needed

Takedown Time Needed

If yes, please list dates or meeting pattern:

Campus *

Preferred Room

Estimated Attendance *

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…

Requestor Information